Provider Demographics
NPI:1508325184
Name:BRIGHTSIDE MEDICAL, P.C.
Entity Type:Organization
Organization Name:BRIGHTSIDE MEDICAL, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATION
Authorized Official - Prefix:
Authorized Official - First Name:MIRENE
Authorized Official - Middle Name:
Authorized Official - Last Name:WINSBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-360-3348
Mailing Address - Street 1:156 2ND ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94105-3724
Mailing Address - Country:US
Mailing Address - Phone:415-360-3348
Mailing Address - Fax:855-350-5708
Practice Address - Street 1:1830 COLONIAL VILLAGE LN
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-6700
Practice Address - Country:US
Practice Address - Phone:415-360-3348
Practice Address - Fax:855-350-5708
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-13
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty