Provider Type Icon

BRUCE B CHISHOLM M.D. NPI 1932206851


NPI Information

NPI: 1932206851
Provider Name: BRUCE B CHISHOLM, M.D.
Classification: Oral & Maxillofacial Surgery - 204E00000X
Entity Type: Individual

PECOS Registration: Yes

CLIA Number: 05D2190920

Address:
39300 BOB HOPE DR
BANNAN BLDG SUITE 1208
RANCHO MIRAGE, CA
ZIP 92270
Phone: (760) 779-9559
Get Directions

Bruce B Chisholm, M.D. is an oral maxillofacial surgery in Rancho Mirage, CA. The provider is oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery. Bruce B Chisholm, M.D. NPI is 1932206851. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

39300 BOB HOPE DR
BANNAN BLDG SUITE 1208
RANCHO MIRAGE, CA
ZIP 92270-203
Phone: (760) 779-9559
Fax: (760) 779-5077

The NPI 1932206851 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The CLIA number assigned to this NPI record is 05D2190920 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/20/2006 and was last updated on 10/6/2011.


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
12086S0122XSurgeryPlastic and Reconstructive SurgeryG81937CALIFORNIANo
2261QA1903XClinic/CenterAmbulatory Surgical10005CALIFORNIANo
3204E00000XOral & Maxillofacial SurgeryG81937CALIFORNIAYes

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
1G22112MEDICARE UPINCALIFORNIA
200G819370MEDICARE ID-TYPE UNSPECIFIEDCALIFORNIA

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.