Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | E3371 | CA |
NPI | 1174541155 |
---|---|
Provider Name | Dr. Bruce Towne Hutchinson |
First Address | Escondido, CA 92025-4604 |
Second Address | Escondido, CA 92025-4604 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2006 |
Last Update Date | 28/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000E33711 | (05) | CA |
756480919 | RAILROAD MEDICARE (01) | CA |
T11658 | (02) | CA |
ZZZ84795Z | BLUE SHIELD OF CA (01) | CA |