Healthcare Provider Details

I. General information

NPI: 1760696728
Provider Name (Legal Business Name): WILLIAM JOHN BRITT PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

53 MANOR DR STE A
BAY POINT CA
94565-6647
US

IV. Provider business mailing address

53 MANOR DR STE A
BAY POINT CA
94565-6647
US

V. Phone/Fax

Practice location:
  • Phone: 925-458-6125
  • Fax:
Mailing address:
  • Phone: 925-458-6125
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA 13607
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: