MEDICARE: HEATHER BRIEN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2086S0129X	Vascular Surgery Physician	G61475	CA

General Provider Information

NPI Number	:	1154375780
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER BRIEN MD

Provider Business Mailing Address
First Line	:	361 HOSPITAL RD STE 227
Second Line	:
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92663-3523
Country	:	US
Telephone Number	:	949-646-6212
Fax Number	:	949-650-3013

Provider Business Practice Location Address
First Line	:	361 HOSPITAL RD STE 227
Second Line	:
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92663-3523
Country	:	US
Telephone Number	:	949-646-6212
Fax Number	:	949-650-3013

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/19/2006
Last Update Date	:	09/08/2020

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Directions to “ HEATHER BRIEN MD” Practice Location

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