MEDICARE: JULIA E. BRYSON M.D.

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	2084N0400X	Neurology Physician	A106988	CA
2	390200000X	Student in an Organized Health Care Education/Training Program
3	208100000X	Physical Medicine & Rehabilitation Physician	A106988	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PO1479128	OTHER	CA	RAILROAD

General Provider Information

NPI Number	:	1609081447
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIA E. BRYSON M.D.

Provider Business Mailing Address
First Line	:	PO BOX 50706
Second Line	:
City	:	SANTA BARBARA
State	:	CA
Zip	:	93150-0706
Country	:	US
Telephone Number	:	805-963-3757
Fax Number	:	805-564-3332

Provider Business Practice Location Address
First Line	:	2080 CENTURY PARK E STE 300
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90067-2006
Country	:	US
Telephone Number	:	310-423-6400
Fax Number	:	310-423-7635

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

Provider Enumeration Date	:	05/14/2007
Last Update Date	:	01/22/2021

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