Healthcare Provider Details

I. General information

NPI: 1518661420
Provider Name (Legal Business Name): ANTHONY BRENNAN OLMERT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2023
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15425 LOS GATOS BLVD STE 120
LOS GATOS CA
95032-2541
US

IV. Provider business mailing address

15425 LOS GATOS BLVD STE 120
LOS GATOS CA
95032-2541
US

V. Phone/Fax

Practice location:
  • Phone: 408-354-3920
  • Fax: 408-354-0782
Mailing address:
  • Phone: 408-354-3920
  • Fax: 408-354-0782

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA197549
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: