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MR. BRUCE K JACKSON M.D. NPI 1609883438


NPI Information

NPI: 1609883438
Provider Name: MR. BRUCE K JACKSON, M.D.
Classification: Internal Medicine - 207RC0000X
Entity Type: Individual

Specialization: Cardiovascular Disease

PECOS Registration: Yes

Address:
520 N PROSPECT AVE
STE. 300
REDONDO BEACH, CA
ZIP 90277
Phone: (310) 372-1156
Get Directions

MR. Bruce K Jackson, M.D. is a cardiovascular disease internal medicine in Redondo Beach, CA with 53 years of experience. The provider is 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. MR. Bruce K Jackson, M.D. NPI is 1609883438. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF CALIFORNIA, GEFFEN SCHOOL OF MEDICINE
Graduation Year:1971

The provider's business location address is:

520 N PROSPECT AVE
STE. 300
REDONDO BEACH, CA
ZIP 90277-041
Phone: (310) 372-1156
Fax: (310) 372-6504

The NPI 1609883438 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Routine electrocardiogram (ekg) using at least 12 leads with interpretation and report (HCPCS:93010)
  • Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function (HCPCS:93306)
  • Exercise or drug-induced heart and blood vessel stress test with ekg monitoring, physician interpretation and report (HCPCS:93018)

The enumeration date for this NPI number is 8/2/2006 and was last updated on 1/27/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207RC0000XInternal MedicineCardiovascular DiseaseA24716CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1WA24716GMEDICARE ID-TYPE UNSPECIFIEDCALIFORNIA
2WA24716HMEDICARE ID-TYPE UNSPECIFIED
3WA24716KMEDICARE ID-TYPE UNSPECIFIEDCALIFORNIA
4WA24716JMEDICARE ID-TYPE UNSPECIFIEDCALIFORNIA
5WA24716ICMEDICARE ID-TYPE UNSPECIFIED
6A24090MEDICARE UPINCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.