Provider Demographics
NPI:1154632057
Name:BRINDLE, TED I (MD)
Entity Type:Individual
Prefix:DR
First Name:TED
Middle Name:I
Last Name:BRINDLE
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Gender:M
Credentials:MD
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Mailing Address - Street 1:10470 OLD PLACERVILLE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95827-2539
Mailing Address - Country:US
Mailing Address - Phone:800-470-0071
Mailing Address - Fax:
Practice Address - Street 1:2 MEDICAL PLAZA DR
Practice Address - Street 2:SUITE 205
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-3043
Practice Address - Country:US
Practice Address - Phone:916-773-8711
Practice Address - Fax:916-773-8712
Is Sole Proprietor?:No
Enumeration Date:2010-06-24
Last Update Date:2015-07-29
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Provider Licenses
StateLicense IDTaxonomies
CAA112507207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADP165ZMedicare PIN