Breneisen, Jeffrey R

Breneisen, Jeffrey R is an sole proprietor health care provider with primary practice located at 1860 Pennsylvania Ave Suite 120, Fairfield CA 94533-3590. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Breneisen, Jeffrey R can be contacted via phone (707) 646-4400.

Contact Information

Primary practice address
1860 Pennsylvania Ave Suite 120 Fairfield CA 94533-3590
Phone: (707) 646-4400
Fax: (707) 646-4401
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X G86677 California

Profile Details

NPI number 1629058615
LBN Legal business name Breneisen, Jeffrey R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 18th, 2006
Last updated Jul 31st, 2015 - about 9 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 1629058615 NPPES
California MEDICAID 00G866770

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