Provider Demographics
NPI:1518900430
Name:BRAUNER, PATRICK JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:JOSEPH
Last Name:BRAUNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2131 HERNDON AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93611-6304
Mailing Address - Country:US
Mailing Address - Phone:559-299-2800
Mailing Address - Fax:559-299-2989
Practice Address - Street 1:2131 HERNDON AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93611-6304
Practice Address - Country:US
Practice Address - Phone:559-299-2800
Practice Address - Fax:559-299-2989
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-14
Last Update Date:2013-11-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA38819207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A38819Medicare PIN
CAA28732Medicare UPIN