Bruce Greenwood Nickerson
Pediatric Pulmonologist Neonatal-Perinatal Doctor
455 S Main St
Orange
, California 92868-3835
Bruce Greenwood Nickerson
Pediatric Pulmonologist Neonatal-Perinatal Doctor
455 S Main St
Orange
, California 92868-3835
(714) 289-4788
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About
Features
Specialties
- Neonatal-Perinatal Doctor
- Pediatric Pulmonologist
Languages spoken
- English
Location
First Address
- Bruce Greenwood Nickerson
- 455 S Main St
- Orange, CA
- Zip : 92868-3835
- Fax : (714) 289-4788
- Phone : (714) 289-4511
Second Address
- Bruce Greenwood Nickerson
- 455 S Main St
- Orange, CA
- Zip : 92868-3835
- Fax : (714) 289-4072
- Phone : (714) 532-8620
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FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 2080N0001X | Neonatal-Perinatal Doctor | G38843 | CA |
| Y | 2080P0214X | Pediatric Pulmonologist | G38843 | CA |
National Provider Identifier
| NPI | 1215026521 |
|---|---|
| Provider Name | Bruce Greenwood Nickerson |
| First Address | Orange, CA 92868-3835 |
| Second Address | Orange, CA 92868-3835 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 12/10/2006 |
| Last Update Date | 08/08/2008 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 00G388430 | (05) | CA |
| A47618 | (02) | CA |
| WG38843F | MEDICARE PTAN (01) | CA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.