Bruce Elliott Smith, MD, MPH

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G069218 Issued in CA

Practice address

799 E Rialto Ave
San Bernardino, CA 92415-0011

Phone

(909) 383-3057

Fax

(909) 383-3212

NPI assigned

Dec 14, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189382400000",
    "number": "1710049945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 HIBISCUS DR",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923736142",
            "telephone_number": "909-383-3057",
            "fax_number": "909-383-3212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "799 E RIALTO AVE",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924150011",
            "telephone_number": "909-383-3057",
            "fax_number": "909-383-3212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "BRUCE",
        "middle_name": "ELLIOTT",
        "name_prefix": "Dr.",
        "credential": "MD, MPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-14",
        "last_updated": "2007-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G069218",
            "primary": true
        },
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "CA",
            "license": "G069218",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Smith
• April Michelle Smith
• Brant Dean Smith, MFTI
• Brea Trinity Smith, PNP
• Brenda Gailya Smith, MSW
• Camille Smith
• Catherine Tillie Smith, LCSW
• Cleo Smith
• Collis Smith
• Daniel Smith

• Family Medicine Physician in San Bernardino, CA
• Providers in San Bernardino, 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 Sep 10, 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.

Verify at the official NPI Registry.