Active NPI
Bruce R Laverty, MD
- Anesthesiology Physician
- Twentynine Palms, CA
National Provider Identifier
1700848769
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- G66108
- Practice address
- Marine Corps Air Ground Combat Center
Box 788250
Twentynine Palms, CA 92278-8250 - Phone
- (760) 830-2188
- NPI assigned
- Apr 5, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | G66108 | CA | Primary |
Addresses
Primary practice location
Marine Corps Air Ground Combat Center
Box 788250
Twentynine Palms, CA 92278-8250
Mailing address
PO Box 788250
Marine Corps Air Ground Combat Center
Twentynine Palms, CA 92278-8250
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G66108 | CA | MD | Anesthesiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144195200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1700848769",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 788250",
"address_2": "MARINE CORPS AIR GROUND COMBAT CENTER",
"city": "TWENTYNINE PALMS",
"state": "CA",
"postal_code": "922788250"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "MARINE CORPS AIR GROUND COMBAT CENTER",
"address_2": "BOX 788250",
"city": "TWENTYNINE PALMS",
"state": "CA",
"postal_code": "922788250",
"telephone_number": "760-830-2188"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAVERTY",
"first_name": "BRUCE",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "CA",
"license": "G66108",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Twentynine Palms, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.