Provider Demographics
NPI:1689773780
Name:SHARI A BRAZINSKY MD INC
Entity Type:Organization
Organization Name:SHARI A BRAZINSKY MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHARI
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:BRAZINSKY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:619-462-9010
Mailing Address - Street 1:6699 ALVARADO RD
Mailing Address - Street 2:SUITE 2308
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92120-5241
Mailing Address - Country:US
Mailing Address - Phone:619-462-9010
Mailing Address - Fax:619-287-9058
Practice Address - Street 1:6699 ALVARADO RD
Practice Address - Street 2:SUITE 2308
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92120-5241
Practice Address - Country:US
Practice Address - Phone:619-462-9010
Practice Address - Fax:619-287-9058
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2009-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G705250Medicaid
CA00G705250Medicaid
W21279Medicare PIN
F28975Medicare UPIN