Provider Demographics
NPI:1336355296
Name:LENKIN, BRETT (MD)
Entity Type:Individual
Prefix:DR
First Name:BRETT
Middle Name:
Last Name:LENKIN
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:PO BOX 280
Mailing Address - Street 2:
Mailing Address - City:SOQUEL
Mailing Address - State:CA
Mailing Address - Zip Code:95073-0280
Mailing Address - Country:US
Mailing Address - Phone:831-464-0207
Mailing Address - Fax:
Practice Address - Street 1:947 BLANCO CIR STE A
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-4461
Practice Address - Country:US
Practice Address - Phone:831-422-5555
Practice Address - Fax:831-422-5199
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2009-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA91927208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation