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:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1629058615 | NPPES |
| California | MEDICAID | 00G866770 |
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