Provider Demographics
NPI:1902867294
Name:LABRECQUE, PIERRE GEORGES (MD)
Entity Type:Individual
Prefix:
First Name:PIERRE
Middle Name:GEORGES
Last Name:LABRECQUE
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 1:120 N MILLER ST
Mailing Address - Street 2:BUILDING C
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93454-4557
Mailing Address - Country:US
Mailing Address - Phone:805-739-0033
Mailing Address - Fax:805-739-1712
Practice Address - Street 1:120 N MILLER ST STE C
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-4557
Practice Address - Country:US
Practice Address - Phone:805-739-0033
Practice Address - Fax:805-739-1712
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-28
Last Update Date:2015-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC043006174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist