RICHARD L BRUCK M D A PROFESSIONAL CORPORATION
NPI 1194913624
Specialist in Upland, CA

NPI Status: Active since October 10, 2007

Contact Information

591 N 13TH AVE
STE.3
UPLAND, CA
ZIP 91786
Phone: (951) 217-8640
Fax: (909) 920-3379

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  • Organization
  • Specialist
  • CLIA Number: 05D2083890
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 09-14-2026

About RICHARD L BRUCK M D A PROFESSIONAL CORPORATION

This page provides the complete NPI Profile along with additional information for Richard L Bruck M D A Professional Corporation, a provider established in Upland, California operating as a Specialist. The healthcare provider is registered in the NPI registry with number 1194913624 assigned on October 2007. The practitioner's primary taxonomy code is 174400000X with license number G30560 (CA). The provider is registered as an organization and their NPI record was last updated 14 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Mr. Richard Lawrence Bruck I Md (Owner)

NPI
1194913624
Provider Name
RICHARD L BRUCK M D A PROFESSIONAL CORPORATION
Entity Type
Organization
Location Address
591 N 13TH AVE STE.3 UPLAND, CA 91786
Location Phone
(951) 217-8640
Location Fax
(909) 920-3379
Mailing Address
591 N 13TH AVE STE.3 UPLAND, CA 91786
Mailing Phone
(909) 985-5885
Mailing Fax
(909) 920-3379
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
10-10-2007
Last Update Date
10-23-2012
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Specialist

Taxonomy Code
174400000X
Type
Other Service Providers
License No.
G30560
License State
CA
Taxonomy Description
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MR. RICHARD LAWRENCE BRUCK I MD

Authorized Official Title
OWNER
Authorized Official Phone
(951) 217-8640

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
A44468MEDICARE UPIN (02)CA 
ZZZ02043ZMEDICARE PIN (08)CA 

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
05D2083890
Facility Type
Physician Office
Certificate Effective Date
September 15, 2024
Certificate Expiration Date
September 14, 2026
Laboratory Director
RICHARD L. ARMOUR, DO
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Richard L Bruck M D A Professional Corporation to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1194913624, we treat the final digit (4) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 66. The final step is to find the difference between that total and the next multiple of ten (70 - 66 = 4).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
1
Unchanged
Pos 3
9
Doubled → 18 → 1 + 8
Pos 4
4
Unchanged
Pos 5
9
Doubled → 18 → 1 + 8
Pos 6
1
Unchanged
Pos 7
3
Doubled → 6
Pos 8
6
Unchanged
Pos 9
2
Doubled → 4
Check
4
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 9 → 18 → 9 9 → 18 → 9 3 → 6 2 → 4

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 1 + 1 + 8 + 4 + 1 + 8 + 1 + 6 + 6 + 4 + 24 = 66

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 66 is 70. The difference is the calculated check digit.

70 - 66 = 4
This NPI is valid
The calculated check digit is 4, which matches the last digit of 1194913624.

Other Providers at the Same Location


The following 3 providers are registered at the same or a nearby location.

Internal Medicine (Cardiovascular Disease)
591 N 13TH AVE, STE 3
UPLAND, CA 91786
Dentist (General Practice)
591 N 13TH AVE, SUITE 4
UPLAND, CA 91786
Internal Medicine (Cardiovascular Disease)
591 N 13TH AVE, SUITE 3
UPLAND, CA 91786

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1194913624, enumerated as an "organization" on October 10, 2007.

The provider is located at 591 N 13TH AVE STE.3 UPLAND, CA 91786 and the phone number is (951) 217-8640.

Specialist with taxonomy code 174400000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.