Provider Demographics
NPI:1164812574
Name:B ELENE BRANDT, MD
Entity Type:Organization
Organization Name:B ELENE BRANDT, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:ELENE
Authorized Official - Last Name:BRANDT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:831-772-0200
Mailing Address - Street 1:601 E ROMIE LN STE 2
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-4229
Mailing Address - Country:US
Mailing Address - Phone:831-772-0200
Mailing Address - Fax:831-772-0205
Practice Address - Street 1:601 E ROMIE LN STE 2
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-4229
Practice Address - Country:US
Practice Address - Phone:831-772-0200
Practice Address - Fax:831-772-0205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-23
Last Update Date:2015-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG64259261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care