Provider Demographics
NPI:1134210628
Name:VISSER, BRENDAN CHRISTOPHER (MD)
Entity type:Individual
Prefix:DR
First Name:BRENDAN
Middle Name:CHRISTOPHER
Last Name:VISSER
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Gender:M
Credentials:MD
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Mailing Address - Street 1:300 PASTEUR DRIVE, SUITE H3680
Mailing Address - Street 2:STANDFORD UNIVERSITY SCHOOL OF MEDICINE
Mailing Address - City:STANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:94305-5655
Mailing Address - Country:US
Mailing Address - Phone:650-721-1693
Mailing Address - Fax:650-736-1663
Practice Address - Street 1:300 PASTEUR DRIVE, SUITE H3680
Practice Address - Street 2:STANDFORD UNIVERSITY SCHOOL OF MEDICINE
Practice Address - City:STANFORD
Practice Address - State:CA
Practice Address - Zip Code:94305-5655
Practice Address - Country:US
Practice Address - Phone:650-721-1693
Practice Address - Fax:650-736-1663
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2012-01-30
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Provider Licenses
StateLicense IDTaxonomies
CAA74028208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery