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BRENNAN MEDICAL GROUP NPI 1962411264


NPI Information

NPI: 1962411264
Provider Name: BRENNAN MEDICAL GROUP
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 05D0973378

Address:
30 BRENNAN ST
WATSONVILLE, CA
ZIP 95076
Phone: (831) 768-0220
Get Directions

BRENNAN MEDICAL GROUP is a family medicine in Watsonville, CA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. BRENNAN MEDICAL GROUP NPI is 1962411264. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

30 BRENNAN ST
WATSONVILLE, CA
ZIP 95076-303
Phone: (831) 768-0220
Fax: (831) 722-1702

The provider's authorized official is Mark Gerard Byrne .
The authorized official title is Owner/physician and has the following contact phone number (831) 768-0220.

The CLIA number assigned to this NPI record is 05D0973378 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/5/2006 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineYes
2207R00000XInternal MedicineX
3207RI0011XInternal MedicineInterventional CardiologyX
4207RP1001XInternal MedicinePulmonary DiseaseX

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
100G743880MEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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