Individual provider Active NPI

Richard Alan Brucker, MD

  • Pediatrics Physician
  • El Segundo, CA
National Provider Identifier
1962792192
Registry record updated May 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A130777 Issued in CA
Practice address
2110 E El Segundo Blvd Ste 210
El Segundo, CA 90245-2743
Phone
(310) 784-8704
Fax
(310) 893-0430
NPI assigned
Apr 8, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A130777 CA Primary

Addresses

Primary practice location

2110 E El Segundo Blvd Ste 210
El Segundo, CA 90245-2743

Mailing address

2110 E El Segundo Blvd Ste 210
El Segundo, CA 90245-2743
Phone (310) 784-8704

Other practice location 1

8700 Beverly Blvd Ste 4221
West Hollywood, CA 90048-1804
Phone (310) 423-4451

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20150303000005 CA Practitioner - Pediatric Medicine 1658507918 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A130777CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cedars-Sinai Medical Center CurrentSince Dec 29, 2014 Accepting new patients
Cedars-Sinai Medical Center CurrentSince Dec 29, 2014 Accepting new patients
Torrance Health Association Inc Past Accepting new patients
Torrance Memorial Medical Center Past Accepting new patients

Locations

2110 E El Segundo Blvd
Ste 210
El Segundo, CA 90245
Phone (310) 784-8704

4140 W 190th St
Torrance, CA 90504
Phone (310) 967-1780

8700 Beverly Blvd
Ste 4221
West Hollywood, CA 90048
Phone (310) 423-4451

8700 Beverly Blvd
West Hollywood, CA 90048
Phone (310) 385-3291

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1302220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746144000000",
    "number": "1962792192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2110 E EL SEGUNDO BLVD STE 210",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902452743",
            "telephone_number": "310-784-8704",
            "fax_number": "310-893-0430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2110 E EL SEGUNDO BLVD STE 210",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902452743",
            "telephone_number": "310-784-8704",
            "fax_number": "310-893-0430"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8700 Beverly Blvd Ste 4221",
            "address_purpose": "LOCATION",
            "city": "West Hollywood",
            "state": "CA",
            "postal_code": "900481804",
            "country_code": "US",
            "telephone_number": "310-423-4451",
            "fax_number": "310-423-2114",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRUCKER",
        "first_name": "RICHARD",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-08",
        "last_updated": "2025-05-02",
        "certification_date": "2025-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A130777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Segundo, CA

Sources for this page

Verify at the official NPI Registry.