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NPI Code Detail

MEDICARE: EILEEN S BREYDE M.D.

MEDICARE: EILEEN S BREYDE 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
1207RR0500XRheumatology PhysicianG69655CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1770585887
Entity Type Code : Individual
Provider Name (Legal Business Name) : EILEEN S BREYDE M.D.
Provider Business Mailing Address
First Line : PO BOX 9602
Second Line :
City : MISSION HILLS
State : CA
Zip : 91346-9602
Country : US
Telephone Number : 818-837-5559
Fax Number : 818-792-4793
Provider Business Practice Location Address
First Line : 191 S BUENA VISTA ST
Second Line : SUITE 100
City : BURBANK
State : CA
Zip : 91505-4554
Country : US
Telephone Number : 818-869-7600
Fax Number : 818-433-3691
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2005
Last Update Date : 09/25/2014

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Directions to “ EILEEN S BREYDE M.D.” Practice Location

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