Frederic Walter Bruhn, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

G43549 Issued in CA

Practice address

4460 E Huntington Ave
Fresno, CA 93702-2962

Phone

(559) 459-4300

Fax

(559) 459-4569

NPI assigned

Aug 29, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228694400000",
    "number": "1629187448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "765 CALLE LOS OLIVOS",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926732717",
            "telephone_number": "559-760-2202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4460 E HUNTINGTON AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937022962",
            "telephone_number": "559-459-4300",
            "fax_number": "559-459-4569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUHN",
        "first_name": "FREDERIC",
        "middle_name": "WALTER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2008-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "G43549",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bruce J Witmer, M.D., Professional Corporation
• Bruce P. Decarlo, MD, Inc.
• Elizabeth J Bruce, MD
• James Michael Bruce, MD
• Kurt Frederick Brueggemann, M.D.
• Samantha Fay Brummond, R1622150725
• Rosemary Brunin, FNP-BC
• Leyhai Lee Bruno
• Salina M Bruno
• Denae Bruns

• Pediatrics Physician in Fresno, CA
• Providers in Fresno, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2008; 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.