Provider Demographics
NPI:1427325760
Name:MORSE, BRUCE MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:MICHAEL
Last Name:MORSE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:149 CHAPEL DR
Mailing Address - Street 2:
Mailing Address - City:MILL VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94941-3168
Mailing Address - Country:US
Mailing Address - Phone:415-383-3560
Mailing Address - Fax:415-383-7086
Practice Address - Street 1:14020 SAN PABLO AVE
Practice Address - Street 2:SUITE A
Practice Address - City:SAN PABLO
Practice Address - State:CA
Practice Address - Zip Code:94806-3619
Practice Address - Country:US
Practice Address - Phone:510-235-1057
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-30
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG23287207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG23287OtherCALIFORNIA LICENSE
CAAM5398587OtherDEA NUMBER