Provider Demographics
NPI:1134232960
Name:BRYSON, MANJEET K (NP RN)
Entity type:Individual
Prefix:
First Name:MANJEET
Middle Name:K
Last Name:BRYSON
Suffix:
Gender:F
Credentials:NP RN
Other - Prefix:
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Mailing Address - Street 1:5116 ASHURST COURT
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758
Mailing Address - Country:US
Mailing Address - Phone:916-271-7355
Mailing Address - Fax:209-334-1430
Practice Address - Street 1:999 SOUTH FAIRMONT STE 225
Practice Address - Street 2:P GILL OBSTETRICS & GYNECOLOGY MEDICAL GRP INC
Practice Address - City:LODI
Practice Address - State:CA
Practice Address - Zip Code:95240
Practice Address - Country:US
Practice Address - Phone:209-334-3343
Practice Address - Fax:209-334-1430
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CARN438150207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA12155OtherNP FURNISHING
CA438150OtherRN LICENSE CA BOARD OF RN