Healthcare Provider Details
I. General information
NPI: 1508027681
Provider Name (Legal Business Name): PAULA BRINKLEY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/20/2008
Last Update Date: 10/25/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
11875 DUBLIN BLVD SUITE B 125
DUBLIN CA
94568-2843
US
IV. Provider business mailing address
3100 TELEGRAPH AVE 2ND FLOOR
OAKLAND CA
94609-3210
US
V. Phone/Fax
- Phone: 925-587-2505
- Fax: 925-587-2511
- Phone: 510-452-5231
- Fax: 510-899-8392
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | C57506 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: