Provider Demographics
NPI: | 1346372661 |
---|---|
Name: | BRETT V. CURTIS, MD, A PROFESSIONAL CORPORATION, INC. |
Entity Type: | Organization |
Organization Name: | BRETT V. CURTIS, MD, A PROFESSIONAL CORPORATION, INC. |
Other - Org Name: | MEDICAL CENTER OF MARIN |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | CEO |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | BRETT |
Authorized Official - Middle Name: | V |
Authorized Official - Last Name: | CURTIS |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MD |
Authorized Official - Phone: | 415-924-4525 |
Mailing Address - Street 1: | 101 CASA BUENA DRIVE |
Mailing Address - Street 2: | |
Mailing Address - City: | CORTE MADERA |
Mailing Address - State: | CA |
Mailing Address - Zip Code: | 94925 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 415-924-4525 |
Mailing Address - Fax: | 415-924-2539 |
Practice Address - Street 1: | 101 CASA BUENA DR |
Practice Address - Street 2: | |
Practice Address - City: | CORTE MADERA |
Practice Address - State: | CA |
Practice Address - Zip Code: | 94925-1709 |
Practice Address - Country: | US |
Practice Address - Phone: | 415-924-4525 |
Practice Address - Fax: | 415-924-2539 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2007-03-12 |
Last Update Date: | 2022-07-11 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
111N00000X, 111NR0400X, 171100000X, 247100000X, 261Q00000X, 261QC1800X, 261QP2000X, 261QU0200X, 261QX0100X, 363A00000X, 363LA2100X, 363LX0106X | ||
CA | 20068 | 208D00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 261QX0100X | Ambulatory Health Care Facilities | Clinic/Center | Occupational Medicine | Group - Multi-Specialty |
No | 111N00000X | Chiropractic Providers | Chiropractor | Group - Multi-Specialty | |
No | 111NR0400X | Chiropractic Providers | Chiropractor | Rehabilitation | Group - Multi-Specialty |
No | 171100000X | Other Service Providers | Acupuncturist | Group - Multi-Specialty | |
No | 208D00000X | Allopathic & Osteopathic Physicians | General Practice | Group - Multi-Specialty | |
No | 247100000X | Technologists, Technicians & Other Technical Service Providers | Radiologic Technologist | Group - Multi-Specialty | |
No | 261Q00000X | Ambulatory Health Care Facilities | Clinic/Center | Group - Multi-Specialty | |
No | 261QC1800X | Ambulatory Health Care Facilities | Clinic/Center | Corporate Health | Group - Multi-Specialty |
No | 261QP2000X | Ambulatory Health Care Facilities | Clinic/Center | Physical Therapy | Group - Multi-Specialty |
No | 261QU0200X | Ambulatory Health Care Facilities | Clinic/Center | Urgent Care | Group - Multi-Specialty |
No | 363A00000X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Group - Multi-Specialty | |
No | 363LA2100X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care | Group - Multi-Specialty |
No | 363LX0106X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Occupational Health | Group - Multi-Specialty |