Provider Demographics
NPI:1851378095
Name:CARRIE, BRIAN JAMES (MD)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:JAMES
Last Name:CARRIE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:515 SOUTH DR
Mailing Address - Street 2:STE 12
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040
Mailing Address - Country:US
Mailing Address - Phone:650-988-7944
Mailing Address - Fax:650-964-3608
Practice Address - Street 1:515 SOUTH DR
Practice Address - Street 2:STE 12
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040
Practice Address - Country:US
Practice Address - Phone:650-988-7944
Practice Address - Fax:650-964-3608
Is Sole Proprietor?:No
Enumeration Date:2005-12-29
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA33408207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A334080Medicaid
CA1851378095Medicare PIN
CAA27144Medicare UPIN