DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

BRUCE B CHISHOLM, M.D.

Active Sole Proprietor

Oral & Maxillofacial Surgery (Physician) · RANCHO MIRAGE, CA

Registration Details

NPI Number
1932206851
Provider Type
Individual
Gender
Male
NPI Issued
Sep 20, 2006 (19.584502016444 yrs)
Last Updated
Oct 6, 2011
Licenses
G81937 (CA)
G81937 (CA)
10005 (CA)
Sole Proprietor
Yes

Practice Information

Address
39300 BOB HOPE DR
BANNAN BLDG SUITE 1208
RANCHO MIRAGE, CA, 922703203
Browse CA providers · Browse ZIP 92270
Phone
7607799559
Fax
7607795077
Primary Specialty
Oral & Maxillofacial Surgery (Physician)
204E00000X
Additional Specialty
Ambulatory Surgical Center
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.