Healthcare Provider Details

I. General information

NPI: 1992877716
Provider Name (Legal Business Name): JASON BRYANT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: JASON SHEN BRYANT MD

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 TROUSDALE DR
BURLINGAME CA
94010-4506
US

IV. Provider business mailing address

1501 TROUSDALE DR
BURLINGAME CA
94010-4506
US

V. Phone/Fax

Practice location:
  • Phone: 650-696-5446
  • Fax:
Mailing address:
  • Phone: 650-696-5446
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA80083
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: