Provider Demographics
NPI:1578779260
Name:GARRETT, BRIAN PAUL (MD, OD)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:PAUL
Last Name:GARRETT
Suffix:
Gender:M
Credentials:MD, OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3835 N FREEWAY BLVD
Mailing Address - Street 2:100
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95834-1928
Mailing Address - Country:US
Mailing Address - Phone:916-576-7900
Mailing Address - Fax:916-285-0338
Practice Address - Street 1:950 GLENN DR STE 235
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-3193
Practice Address - Country:US
Practice Address - Phone:916-990-9159
Practice Address - Fax:916-988-4937
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2018-03-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2002007094152W00000X, 207W00000X
KY454672084P0800X
CAA1446302084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No152W00000XEye and Vision Services ProvidersOptometrist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology