Individual provider · NPI-1

Dr. Bruce Wayne Fissette, DC, PhD

Chiropractor, Radiology · Westminster, CA

NPI number1073535357
StatusActive
Last updated in NPPESJul 31, 2007

Details

NPI
1073535357
Entity type
Individual (NPI-1)
Name
Dr. Bruce Wayne Fissette
Credential
DC, PhD
Sex
Male
Sole proprietor
Yes
Enumeration date
Jul 24, 2006
Last updated
Jul 31, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
111NR0200X Chiropractor, RadiologyRHC147634CAYes
111N00000X ChiropractorDC26387CA

Practice location

7020 Trask Ave
Westminster, CA 92683-2622

Phone 949-673-3154 · Fax 949-723-8348

Mailing address

1809 W Bay Ave
Newport Beach, CA 92663-4516

Phone 949-673-3154 · Fax 949-723-8348

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