Bruke Tedla

Primary specialty

Adult Congenital Heart Disease PhysicianTaxonomy code 207RA0002X

License

A160609 Issued in CA

Practice address

11324 Anderson St
Loma Linda, CA 92350-1728

Phone

(909) 558-8590

NPI assigned

Jan 29, 2018

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

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

Specialty

Cardiovascular Disease (Cardiology)

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Faculty Physicians and Surgeons of LlusmGroup PAC ID 1153227814, 1,313 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Loma Linda University Medical Center Hospital, Loma Linda, CA, CCN 050327

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Faculty Physicians and Surgeons of Llusm

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Apple Valley, CA
  • NPI 1205009917
  Medicare reassignment Care Compare group NPD
• Faculty Physicians and Surgeons of Llusm

  • Neurological Surgery Physician
  • Loma Linda, CA
  • NPI 1194775122
  NPD
• Faculty Physicians and Surgeons of Llusm

  • Obstetrics & Gynecology Physician
  • Rancho Cucamonga, CA
  • NPI 1568113827

  Adult Congenital Heart Disease

  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Loma Linda University Medical Center

  • General Acute Care Hospital
  • Loma Linda, CA
  • NPI 1194731935
  Care Compare affiliation

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

{
    "created_epoch": "1517184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762819200000",
    "number": "1982102539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2068 ORANGE TREE LN STE 215",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923744555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11324 ANDERSON ST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923501728",
            "telephone_number": "909-558-8590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEDLA",
        "first_name": "BRUKE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-29",
        "last_updated": "2025-11-11",
        "certification_date": "2025-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Adult Congenital Heart Disease",
            "state": "CA",
            "license": "A160609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melanie Emad Tawfik, MD
• Christina St Clair Taylor, CRNA
• Natalie Ecliseria Taylor, FNP-C
• Thomas Wesley Taylor Jr., R.R.T.
• Eric Theodore Teacher, M.D.
• Devanie S Teel, M.D.
• Lillian Tefilin
• Seigmund Teichman, M.D.
• Gerardo Antonio Tellez, MD
• Rachael Tena

• Internal Medicine Physician in Loma Linda, CA
• Providers in Loma Linda, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.