Chisholm Bruce B MC ASC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

G81937 Issued in CA

Legal business name

CHISHOLM BRUCE B MC ASC

Practice address

39300 Bob Hope Dr
Bannan BLDG 1208
Rancho Mirage, CA 92270-3203

Phone

(760) 779-9559

Fax

(760) 779-5077

NPI assigned

May 23, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Bruce B Chisholm, MD

Title

Ceo

Phone

(760) 779-9559

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1700096005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39300 BOB HOPE DR",
            "address_2": "BANNAN BLDG 1208",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922703203",
            "telephone_number": "760-779-9559",
            "fax_number": "760-779-5077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39300 BOB HOPE DR",
            "address_2": "BANNAN BLDG 1208",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922703203",
            "telephone_number": "760-779-9559",
            "fax_number": "760-779-5077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHISHOLM BRUCE B MC ASC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CHISHOLM",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "760-779-9559",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": "G81937",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IMQ ASC ACCREDITATION",
            "identifier": "10005",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Martha Coyle Chesworth, CCRN
• Yi-Ju Chiang, MD
• Diana Chien, DO
• Aimmee S Chin, M.D.
• Susan Chinskey, MFT
• Bruce B Chisholm, M.D.
• David Phuisang Choe, M.D.
• Steve Choe, M.D.
• Tiffany Chow, MD
• Christian J Luzar DMD Inc

• Ambulatory Surgical Clinic/Center in Rancho Mirage, CA
• Providers in Rancho Mirage, CA by specialty
• Ambulatory Surgical Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.