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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
A24716 | CA | Allopathic & Osteopathic Physicians |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
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 |
Street Address |
520 N PROSPECT AVE STE. 300 |
City | REDONDO BEACH |
State | CA |
Zip Code | 90277-3041 |
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 |
Find all providers in the same location |
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 |
Find all providers in zip 90277 |
Taxonomy Code | 207RC0000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Cardiovascular Disease |
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. |
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 |
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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 |
1336754472 | Ankur Gupta Medical Corporation | Internal Medicine | 820 S Akers St Ste 130, Visalia, CA 93277-8346 | 2020-09-15 |
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 |
Find all providers with the same taxonomy |
City | REDONDO BEACH |
Zip Code | 90277 |
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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.