Provider Demographics
NPI:1770531816
Name:FIRST, BRIAN PETER (MD)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:PETER
Last Name:FIRST
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 1:4282 GENESEE AVE
Mailing Address - Street 2:#103
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92117-4961
Mailing Address - Country:US
Mailing Address - Phone:858-292-0108
Mailing Address - Fax:858-292-9097
Practice Address - Street 1:4282 GENESEE AVE
Practice Address - Street 2:#103
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92117-4961
Practice Address - Country:US
Practice Address - Phone:858-292-0108
Practice Address - Fax:858-292-9097
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2010-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA33952207R00000X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWA33952BMedicare ID - Type UnspecifiedBRIAN FIRST PERSONAL
CAW7053Medicare ID - Type UnspecifiedPRACTICE PROVIDER I.D
CAA27312Medicare UPIN