Provider Demographics
NPI:1346449287
Name:BRISCOE, STEVEN ALLEN (CRT)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:ALLEN
Last Name:BRISCOE
Suffix:
Gender:M
Credentials:CRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15633 GARLOCK LN
Mailing Address - Street 2:
Mailing Address - City:PRATHER
Mailing Address - State:CA
Mailing Address - Zip Code:93651-9707
Mailing Address - Country:US
Mailing Address - Phone:559-323-9685
Mailing Address - Fax:
Practice Address - Street 1:15633 GARLOCK LN
Practice Address - Street 2:
Practice Address - City:PRATHER
Practice Address - State:CA
Practice Address - Zip Code:93651-9707
Practice Address - Country:US
Practice Address - Phone:559-323-9685
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-12
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARHT604242471C3402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471C3402XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistRadiography