Basic Information
Provider Information
NPI: 1003003864
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LLOYD
FirstName: BRUCE
MiddleName: HOWARD
NamePrefix: DR.
NameSuffix:  
Credential: M. D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 69-846 HIGHWAY 111, SUITE D
Address2: TRAVEL MEDICINE
City: RANCHO MIRAGE
State: CA
PostalCode: 922702857
CountryCode: US
TelephoneNumber: 7603210967
FaxNumber: 7603469852
Practice Location
Address1: TRAVEL MEDICINE, 69-846 HIGHWAY 111, 92270-2857
Address2: SUITE D
City: RANCHO MIRAGE
State: CA
PostalCode: 922702857
CountryCode: US
TelephoneNumber: 7603210967
FaxNumber: 7603469852
Other Information
ProviderEnumerationDate: 09/26/2007
LastUpdateDate: 09/26/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2083P0500XCFE24850CAY Allopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine

No ID Information.


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