Provider Demographics
NPI:1598875452
Name:BREITNER, JOHN CARL SUMMER (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:CARL SUMMER
Last Name:BREITNER
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
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Mailing Address - Street 1:454 VILLAGGIO S
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-6397
Mailing Address - Country:US
Mailing Address - Phone:514-441-1776
Mailing Address - Fax:514-221-4700
Practice Address - Street 1:454 VILLAGGIO S
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-6397
Practice Address - Country:US
Practice Address - Phone:514-441-1776
Practice Address - Fax:514-221-4700
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WA444042083P0901X, 2084P0805X
CAC1340382084P0805X, 2083P0901X
MT333882084P0805X, 2083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine