Provider Demographics
NPI:1285755983
Name:RIZZO, BRUCE (DC)
Entity type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:
Last Name:RIZZO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6330 TELEGRAPH AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-1329
Mailing Address - Country:US
Mailing Address - Phone:510-601-6330
Mailing Address - Fax:510-601-6331
Practice Address - Street 1:6330 TELEGRAPH AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-1329
Practice Address - Country:US
Practice Address - Phone:510-601-6330
Practice Address - Fax:510-601-6331
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27160111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor