MR. BRUCE K JACKSON


Address: 520 N Prospect Ave, Ste. 300, Redondo Beach, CA 90277-3041
Phone: 3103721156

MR. BRUCE K JACKSON (NPI# 1609883438) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1609883438
Entity Type Individual
Full Name MR. BRUCE K JACKSON
Credential M.D.
Practice Address 520 N Prospect Ave
Ste. 300
Redondo Beach
CA 90277-3041
Mailing Address 1360 W 6th St
Suite 200
San Pedro
CA 90732-3514
Practice Telephone 3103721156
Practice Fax Number 3103726504
Mailing Telephone 3105479922
Mailing Fax Number 3105474673
Enumeration Date 2006-08-02
Last Update Date 2015-01-27
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207RC0000X Internal Medicine
Specialization: Cardiovascular Disease
A24716 CA Allopathic & Osteopathic Physicians

Other Providers BRUCE JACKSON

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1992039291 Bruce C. Jackson Chiropractor 201 Brighton Park Blvd., Ste. 4, Frankfort, KY 40601-8447 2009-09-21
1851430532 Bruce W Jackson Dentist 111 Lilac Dr, Liberal, KS 67901 2007-02-06
1124072087 Bruce L Jackson Physician Assistant 15863 Kasota Rd, Apple Valley, CA 92307-4507 2006-05-22
1598133571 Bruce Jackson Registered Nurse 2828 1st Ave Ste 400, Huntington, WV 25702-1236 2015-09-09
1467711986 Bruce Jackson Case Manager/Care Coordinator 5715 S Broadway, Los Angeles, CA 90037-4131 2012-05-04
1598819567 Bruce E Jackson Counselor 5455 Almira Dr Se, Bremerton, WA 98311-8330 2007-01-23
1720039878 Bruce Arden Jackson II Dentist 4829 E Beltline Ave Ne, Grand Rapids, MI 49525-9747 2006-05-13

Office Location

Street Address 520 N PROSPECT AVE
STE. 300
City REDONDO BEACH
State CA
Zip Code 90277-3041

Providers in the same location

NPI Name Taxonomy Address Enumeration
1699779660 William James Wickwire Dermatology 520 N Prospect Ave, Ste 302, Redondo Beach, CA 90277-3043 2005-06-08
1265980437 Nitin Bhakta Pharmacist 520 N Prospect Ave, Suite 110, Redondo Beach, CA 90277-3041 2016-09-16
1356799415 A. R. I. Clinical Trials, Inc. Clinic/Center 520 N Prospect Ave, Suite 201, Redondo Beach, CA 90277-3041 2016-05-31
1962866483 Jamie W Wu Registered Nurse 520 N Prospect Ave, Suite 203, Redondo Beach, CA 90277-3041 2016-04-11
1225463797 Los Angeles Ent Facial Plastics Center, Inc Clinic/Center 520 N Prospect Ave, Suite 302, Redondo Beach, CA 90277-3041 2013-09-03
1053669390 Brenda Shen Family Medicine 520 N Prospect Ave, Suite 103, Redondo Beach, CA 90277-3041 2012-08-16
1346536968 Sitaraman Jyotheeswaran Md Facp A Medical Corporation Internal Medicine 520 N Prospect Ave, Suite # 304, Redondo Beach, CA 90277-3041 2011-06-22
1952617342 Lewis Wong Family Medicine 520 N Prospect Ave, Redondo Beach, CA 90277-3041 2010-08-24
1942452453 Michael S. Greiner Chiropractor 520 N Prospect Ave, Ste # 201, Redondo Beach, CA 90277-3041 2008-10-15
1164672796 Melody Lee Nurse Practitioner 520 N Prospect Ave, Redondo Beach, CA 90277-3041 2008-09-18
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1780215103 Robert John Coffman Psychologist 316b North Pacific Coast Hwy., Redondo Beach, CA 90277 2020-02-04
1952949786 Anne E Pitts Dietitian, Registered 360 The Village Drive Unit 207, Redondo Beach, CA 90277 2019-12-11
1558916841 Dana Bryon Staub Social Worker 205 Ave. I, Suite 17, Redondo Beach, CA 90277 2019-08-05
1376033860 Lisa Ann Graziano Marriage & Family Therapist 514 N. Prospect Avenue, Suite 111 Lower Level, Redondo Beach, CA 90277 2018-05-10
1275981326 Carla Marie Vasquez Marriage & Family Therapist 901 N. Pacific Coast Highway, 200a, Redondo Beach, CA 90277 2016-05-31
1154793628 Marianne M. Cuttic, Dpm, Inc Podiatrist 1970 S Prospect Avenue, Suite 4, Redondo Beach, CA 90277 2015-10-23
1841682994 Mary Schopfel Counselor 901 Pacific Coast Highway, 200a, Redondo Beach, CA 90277 2015-02-26
1700287141 Rose Ross Marriage & Family Therapist 901 North Pacific Coast Highway, Suite 200a, Redondo Beach, CA 90277 2014-09-04
1912307661 Gale Hazeltine Physical Therapist 409 N PCh Hwy # 308, Redondo Beach, CA 90277 2014-08-31
1194135889 Physical Therapy Concierge Service Inc Clinic/Center 704 N. Irena, B, Redondo Beach, CA 90277 2014-05-02
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Taxonomy Information

Taxonomy Code 207RC0000X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Cardiovascular Disease

Taxonomy Definition

An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1639357775 Reena Patel Internal Medicine 514 N Prospect Ave, 103, Redondo Beach, CA 90277-3036 2008-01-31
1679580401 Gary L Kissel Internal Medicine 520 N Prospect Ave, Ste. 300, Redondo Beach, CA 90277-3041 2006-08-02

Providers in the same taxonomy and state

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1962000141 Suman S Kuppahally, M.d. Inc Internal Medicine 2505 Samaritan Dr Ste 600, San Jose, CA 95124-4017 2020-10-11
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1295351740 Penciu Medical Apmc Internal Medicine 1585 Sierra Madre Villa Ave, Pasadena, CA 91107-1259 2020-06-21
1679113336 La Pulse Medical, Inc Internal Medicine 14558 Sylvan St Ste 105, Van Nuys, CA 91411-2324 2020-01-10
1770122871 John R. Nelson M.d. Inc. Internal Medicine 7061 N Whitney Ave Ste 101, Fresno, CA 93720-8025 2020-01-06
1730725789 Norcal Medical Services, Inc Internal Medicine 2267 Lava Ridge Ct, Roseville, CA 95661-3062 2019-11-25
1932750957 Enloe Medical Center Internal Medicine 1430 Esplanade Ste 6, Chico, CA 95926-3366 2019-09-20
1528610425 Nicholas Russell Internal Medicine 2967 N Moorpark Rd, Thousand Oaks, CA 91360-4573 2019-07-10
1043871627 Gy Medical Clinic Inc Internal Medicine 7400 Van Nuys Blvd Ste 112, Van Nuys, CA 91405-1972 2019-06-25
1902465792 Pacific Heart & Vascular Internal Medicine 1234 W. Chapman Ave, Ste #101, Orange, CA 92868-2862 2019-06-06
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Competitor

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City REDONDO BEACH
Zip Code 90277

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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