Bruce Mutter, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G33145 Issued in CA

Practice address

955 W Imperial Hwy Ste 110
Brea, CA 92821-3814

Phone

(714) 449-6900

NPI assigned

Aug 2, 2005

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Providence Medical Foundation

  • Family Medicine Physician
  • Brea, CA
  • NPI 1871607762
  Medicare reassignment NPD
• Providence Medical Foundation

  • Family Medicine Physician
  • Anaheim, CA
  • NPI 1639715709
  NPD
• Queen of the Valley Medical Association

  • Gynecology Physician
  • Napa, CA
  • NPI 1649260126
  NPD (past)
• St Jude Hospital Inc

  • General Acute Care Hospital
  • Fullerton, CA
  • NPI 1194926279
  NPD (past)
• St Jude Hospital Yorba Linda

  • Family Medicine Physician
  • Fullerton, CA
  • NPI 1619273059
  NPD (past)
• St Jude Hospital Yorba Linda

  • Family Medicine Physician
  • Diamond Bar, CA
  • NPI 1629374053
  NPD (past)

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636416000000",
    "number": "1861493736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 W IMPERIAL HWY STE 110",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928213814",
            "telephone_number": "714-449-6900",
            "fax_number": "714-449-6907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "955 W IMPERIAL HWY STE 110",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928213814",
            "telephone_number": "714-449-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUTTER",
        "first_name": "BRUCE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-02",
        "last_updated": "2021-11-09",
        "certification_date": "2021-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G33145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bmutter1373151@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "955 W Imperial Hwy Ste 110",
            "city": "Brea",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928213814",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Crystal Fukumi Muraoka, O.D.
• Tadashi Ron Murase, D.C.
• Mary C. Murdock, PA-C
• Analisa Murillo, PT, DPT
• Elaine Michelle Murphy, MS, LMFT
• Nada Traboulsi DDS, Inc.
• Ann Sachiko Nakagawa, P.T, DPT
• Naptime Homecare Inc.
• Kristin Nason, RDN
• Natasha D. Marshall, DPM, Podiatry Corporation

• Family Medicine Physician in Brea, CA
• Providers in Brea, 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 Nov 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.