Bruce P. Decarlo, MD, Inc.

Primary specialty

Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X

License

C51535 Issued in CA

Legal business name

BRUCE P. DECARLO, MD, INC.

Practice address

373 Imperial Hwy
Fullerton, CA 92835-1040

Phone

(714) 441-1242

Fax

(714) 441-2449

NPI assigned

Oct 24, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Richard Schork

Title

Vice President

Phone

(714) 441-1242

Specialties & licenses 1

Addresses

Other names 1

• Thomas J. Purtzer, MD, Inc. Former legal business name

Tax ID family

Bruce P Decarlo MD Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Bruce P. Decarlo, MD, Inc.

  • Physical Medicine & Rehabilitation Physician
  • Fresno, CA
  • NPI 1215011580
  NPD tax ID
• Bruce P. Decarlo, MD, Inc.

  • Physical Medicine & Rehabilitation Physician
  • Sacramento, CA
  • NPI 1801970173
  NPD tax ID

Locations

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1841374105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "373 IMPERIAL HWY",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928351040",
            "telephone_number": "714-441-1242",
            "fax_number": "714-441-2449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "373 IMPERIAL HWY",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928351040",
            "telephone_number": "714-441-1242",
            "fax_number": "714-441-2449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRUCE P. DECARLO, MD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SCHORK",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "714-441-1242"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "CA",
            "license": "C51535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Thomas J. Purtzer, MD, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Catherine Brown
• Gray Clark Brown, L.C.S.W.
• Jeanie Brown, RAS
• Timothy Brown
• Yessica Brown
• Bruce Park, M.D. a Professional Corporation
• April Ann Brunetti, D.C.
• Bryan H Chung DMD Ms Inc (Brightal Dental Group)
• Latanya Marie Bryant
• Christina Buchanan

• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Fullerton, CA
• Providers in Fullerton, CA by specialty
• Sports Medicine (Physical Medicine & Rehabilitation) Physician 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.