Healthcare Provider Details

I. General information

NPI: 1497409932
Provider Name (Legal Business Name): BRIANNA KATHLEEN HITE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2022
Last Update Date: 03/05/2024
Certification Date: 03/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38400 BOB WILSON DRIVE
SAN DIEGO CA
92134-5000
US

IV. Provider business mailing address

PSC 482
FPO AP
96362
US

V. Phone/Fax

Practice location:
  • Phone: 443-486-8186
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number0101279321
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: