Provider Demographics
NPI:1760014120
Name:GERIHEAL PC
Entity Type:Organization
Organization Name:GERIHEAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:
Authorized Official - Last Name:BRINLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:310-905-4581
Mailing Address - Street 1:4900 CALIFORNIA AVE STE 210B
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-7080
Mailing Address - Country:US
Mailing Address - Phone:310-963-0365
Mailing Address - Fax:
Practice Address - Street 1:4900 CALIFORNIA AVE STE 210B
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-7080
Practice Address - Country:US
Practice Address - Phone:310-963-0365
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-04
Last Update Date:2020-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty