Provider Demographics
NPI:1821401159
Name:GAILLIOT, BRITAIN (MD)
Entity Type:Individual
Prefix:DR
First Name:BRITAIN
Middle Name:
Last Name:GAILLIOT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2730 STOCKTON BLVD
Mailing Address - Street 2:TICON III, ROOM 2200
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817-2217
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2730 STOCKTON BLVD
Practice Address - Street 2:TICON III, ROOM 2200
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-2217
Practice Address - Country:US
Practice Address - Phone:301-744-0861
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-04
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-163672085R0202X
AZ649072085R0202X
390200000X
CARHL002029052085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program