Provider Demographics
NPI:1457421349
Name:BELL, BRUCE (DC, QME)
Entity type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:
Last Name:BELL
Suffix:
Gender:M
Credentials:DC, QME
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10039 VINE ST
Mailing Address - Street 2:
Mailing Address - City:LAKESIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92040-3120
Mailing Address - Country:US
Mailing Address - Phone:619-390-9975
Mailing Address - Fax:858-633-4690
Practice Address - Street 1:1750 E PALOMAR ST
Practice Address - Street 2:SUITE 7
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91913-3731
Practice Address - Country:US
Practice Address - Phone:619-472-2225
Practice Address - Fax:866-590-2183
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2019-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC15863111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation