Breckenridge, Laura

Breckenridge, Laura is an individual health care provider with primary practice located at 1001 Sneath Ln Suite 104, San Bruno CA 94066-2308. She recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as her primary health care specialty. Breckenridge, Laura can be contacted via phone (650) 873-4545.

Contact Information

Primary practice address
1001 Sneath Ln Suite 104 San Bruno CA 94066-2308
Phone: (650) 873-4545
Fax: (650) 873-4544
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207RS0010X G64476 California

Profile Details

NPI number 1013091594
LBN Legal business name Breckenridge, Laura
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 24th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013091594 NPPES
California MEDICAID 00G644760

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