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LAURA BRECKENRIDGE NP

Sports Medicine >> Internal Medicine >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1013091594

Individual Registrant:
 LAURA  BRECKENRIDGE NP
Gender: F
Not Sole Proprietor

Location and contact information for practice:
1001 SNEATH LN SUITE 104 SAN BRUNO, CA 94066-2308 US
Tel: 650-873-4545  Fax: 650-873-4544

Contact information for business:
308 22ND AVE  SAN MATEO, CA 94403-1710 US
Tel: 650-357-7971  Fax: --

Registration Information:
NPI: 1013091594
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207RS0010XAllopathic & Osteopathic Physicians
Internal Medicine
Sports Medicine
CAG64476

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
00G644760CA05




HEALTH CARE JOBS CA - Page 1



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