Bruce Jordan Wilbur, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G77764 Issued in CA

Practice address

160 Glen Cove Marina Rd
Suite103
Vallejo, CA 94591

Phone

(707) 638-5700

Fax

(707) 638-5750

NPI assigned

Mar 23, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287014400000",
    "number": "1619094687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 GLEN COVE MARINA RD",
            "address_2": "SUITE103",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "94591",
            "telephone_number": "707-638-5700",
            "fax_number": "707-638-5750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 GLEN COVE MARINA RD",
            "address_2": "SUITE103",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "94591",
            "telephone_number": "707-638-5700",
            "fax_number": "707-638-5750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILBUR",
        "first_name": "BRUCE",
        "middle_name": "JORDAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-23",
        "last_updated": "2010-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G77764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul B. Whitney, OTR
• Linda Susan Whitt
• David L. Wicker, MD
• Robert A. Wickham, MD
• Robert Leonard Wiebe, M.D.
• Denise Wilder
• William C. Vizzolini, D.D.S., Inc.
• David B. Williams, MD
• Donna Jean Williams, RDH
• Gray R. Williams, DPM

• Family Medicine Physician in Vallejo, CA
• Providers in Vallejo, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.