Doctor Name: | DR. GEORGE BRIDI |
NPI Number: | 1770709594 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | A25779 |
Business Practice Address: | 12521 Nedra Dr Granada Hills, CA - 913441847 |
Business Phone Number: | 8183684171 |
Business Fax Number: | |
Mailing Address: | 12521 Nedra Dr, GRANADA HILLS |
State: | CA |
Postal Code: | 913441847 |
Phone Number: | 8183684171 |
Fax Number: | |
NPI Enumeration Date: | 04/18/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | A25779 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |