Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | G46615 | CA |
NPI | 1043224686 |
---|---|
Provider Name | Mr. Bruce Abraham Greenfield |
First Address | Los Angeles, CA 90015-3048 |
Second Address | Los Angeles, CA 90015-3048 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G466150 | (05) | CA |
A92663 | (02) | CA |