Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QS0010X | Family Doctor - Sports Medicine | G47710 | CA |
NPI | 1225184518 |
---|---|
Provider Name | Bruce R Hoyle |
First Address | Orange, CA 92868-4231 |
Second Address | Orange, CA 92868-4231 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2007 |
Last Update Date | 23/04/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A50786 | (02) | CA |