Provider Demographics
NPI:1376201129
Name:BRITTO, PAUL J (CPT14446)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:J
Last Name:BRITTO
Suffix:
Gender:M
Credentials:CPT14446
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4532 SILVERCREST WAY
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94531-7650
Mailing Address - Country:US
Mailing Address - Phone:925-450-3500
Mailing Address - Fax:
Practice Address - Street 1:4532 SILVERCREST WAY
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94531-7650
Practice Address - Country:US
Practice Address - Phone:925-450-3500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-29
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA87-3706995OtherOTHER