Most Relevant Information
Provider Data
| NPI Number: | 1003575747 |
| Provider Name: | BRUCE JOHNSTON |
| Entity Type: | Individual |
| Taxonomy Code: | 2255A2300X |
| Specialty: | Specialist/Technologist |
| License Number: | ATR-001165 |
Most Important Dates
| Enumeration Date: | 12/09/2021 |
| Last Updated: | 12/09/2021 |
Provider Practice Location
2000 TRIDENT WAY
SAN DIEGO
CA
921555599
Practice Location Phone/Fax
| Phone: | 5136416644 |
| Fax: |
Provider Mailing Location
3398 N SIERRA SPRINGS DR
TUCSON
AZ
857126671
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |