Healthcare Provider Details

I. General information

NPI: 1841115540
Provider Name (Legal Business Name): BRIM LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1423 21ST ST
SACRAMENTO CA
95811-5208
US

IV. Provider business mailing address

1423 21ST ST
SACRAMENTO CA
95811-5208
US

V. Phone/Fax

Practice location:
  • Phone: 206-886-0201
  • Fax:
Mailing address:
  • Phone: 206-886-0201
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: CARLOS GUERRA
Title or Position: MANAGER
Credential:
Phone: 206-886-0201