Provider Demographics
NPI:1174541155
Name:HUTCHINSON, BRUCE TOWNE (DPM)
Entity type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:TOWNE
Last Name:HUTCHINSON
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1027 E GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-4604
Mailing Address - Country:US
Mailing Address - Phone:760-489-5858
Mailing Address - Fax:760-489-9752
Practice Address - Street 1:1027 E GRAND AVE
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-4604
Practice Address - Country:US
Practice Address - Phone:760-489-5858
Practice Address - Fax:760-489-9752
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE3371213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ84795ZOtherBLUE SHIELD OF CA
CA000E33711Medicaid
CA756480919OtherRAILROAD MEDICARE
CAT11658Medicare UPIN
CA0526100001Medicare NSC
CA000E33711Medicaid