Doctor Name: | DR. BRETT MENSH |
NPI Number: | 1851610190 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D., PH.D. |
License Number: | C53997 |
Business Practice Address: | 101 Casa Buena Dr Corte Madera, CA - 949251762 |
Business Phone Number: | 4159244525 |
Business Fax Number: | |
Mailing Address: | 369-b Third St. #268, SAN RAFAEL |
State: | CA |
Postal Code: | 94901 |
Phone Number: | 4153159848 |
Fax Number: | |
NPI Enumeration Date: | 05/26/2010 |
NPI Last Update Date: | 05/26/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | C53997 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |