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NPI Code Detail

MEDICARE: BRETT MICHAEL LONDON D.O.

MEDICARE: BRETT MICHAEL LONDON D.O.
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
1390200000XStudent in an Organized Health Care Education/Training ProgramTL-4021CO
2207Q00000XFamily Medicine Physician13489CA

General Provider Information

NPI Number : 1730474933
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRETT MICHAEL LONDON D.O.
Provider Business Mailing Address
First Line : 130 SUTTER ST FL 2
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94104-4009
Country : US
Telephone Number : 415-658-6791
Fax Number : 415-520-0904
Provider Business Practice Location Address
First Line : 1801 SHATTUCK AVE STE A
Second Line :
City : BERKELEY
State : CA
Zip : 94709-1872
Country : US
Telephone Number : 888-663-6331
Fax Number : 415-252-7176
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2011
Last Update Date : 12/17/2025

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Directions to “ BRETT MICHAEL LONDON D.O.” Practice Location

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