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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DR. MARK NEIL BRUCKNER M.D.
NPI 1245226232
Pediatrics in Simi Valley, CA

Active since September 23, 2005CLIA 05D0715851 · Waiver
2876 SYCAMORE DR, SUITE 302, SIMI VALLEY, CA 93065(805) 522-4400 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Mark Neil Bruckner M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. MARK NEIL BRUCKNER M.D. (NPI 1245226232) is an individual pediatrics provider in Simi Valley, California, licensed in California (G50614) and active in the NPI registry since September 2005. He holds a CLIA Waiver certificate valid through April 12, 2027.

NPPES Registry Identity

NPI1245226232
Entity TypeIndividualMale
Primary Taxonomy208000000X
Provider Legal NameDR. MARK NEIL BRUCKNERCredential: M.D.
Location Address2876 SYCAMORE DR, SUITE 302Simi Valley, CA 93065-1550
Mailing Address2668 Via Zurita CtSanta Rosa Valley, CA 93012-9336 · (805) 491-2641
Phone(805) 522-4400
Sole ProprietorNo
Enumeration DateSeptember 23, 2005
Last NPPES UpdateJuly 13, 2026
✔ NPI 1245226232 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in CA · G50614
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
2876 SYCAMORE DR, Simi Valley, CA 93065
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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D0715851

Mark Bruckner · Simi Valley, CA
Active · expires Apr 12, 2027
CLIA Number05D0715851
Laboratory TypePhysician Office
Certificate Effective DateApril 13, 2025
Certificate Expiration DateApril 12, 2027
Laboratory DirectorMark N. Bruckner
Laboratory Phone(805) 522-4400
Laboratory LocationMark Bruckner2876 Sycamore Dr Suite 302, Simi Valley, CA 93065
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TIM MCNICOLL MD INC
Family Medicine
2876 SYCAMORE DR, SUITE 101
SIMI VALLEY, CA 93065
Ventura County (805) 527-6424
DR. ABDUL W NAWABI M.D.
Family Medicine
2876 SYCAMORE DR, SUITE 101
SIMI VALLEY, CA 93065
Ventura County (805) 527-6424
MRS. JENNIFER LAUREN LANE PA
Physician Assistant (Medical)
2876 SYCAMORE DR
SIMI VALLEY, CA 93065
Ventura County (805) 527-6424
MRS. SERENA MAYE FRIEDMAN M.D.
Family Medicine
2876 SYCAMORE DR, SUITE 304
SIMI VALLEY, CA 93065
Ventura County (805) 526-9242
ADVANCED PAIN MEDICAL GROUP, INC
Non-Pharmacy Dispensing Site
2876 SYCAMORE DR, SUITE 203
SIMI VALLEY, CA 93065
Ventura County (818) 348-7246
JONATHAN KUROHARA MD INC
Family Medicine
2876 SYCAMORE DR, #101
SIMI VALLEY, CA 93065
Ventura County (805) 527-6424
ADVANCED PAIN MEDICAL GROUP, INC
Pain Medicine (Interventional Pain Medicine)
2876 SYCAMORE DR, SUITE 203
SIMI VALLEY, CA 93065
Ventura County (818) 348-7246
SERENA M. FRIEDMAN M.D., A MEDICAL CORPORATION
Internal Medicine
2876 SYCAMORE DR, SUITE 304
SIMI VALLEY, CA 93065
Ventura County (805) 526-9242

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mark Bruckner's NPI number?

The NPI number for Mark Bruckner is 1245226232. It was assigned to this individual provider in the NPPES registry on September 23, 2005.

Where is Mark Bruckner located?

Mark Bruckner practices at 2876 Sycamore Dr Suite 302, Simi Valley, CA 93065. The listed phone number is (805) 522-4400.

What is Mark Bruckner's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Does Mark Bruckner hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D0715851) is associated with this NPI, valid through April 12, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Mark Bruckner was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 28 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.