Healthcare Provider Details

I. General information

NPI: 1689869976
Provider Name (Legal Business Name): BRENDA LEIGH RINGEL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/10/2007
Last Update Date: 05/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12625 HIGH BLUFF DR STE 202
SAN DIEGO CA
92130-2053
US

IV. Provider business mailing address

12625 HIGH BLUFF DR STE 202
SAN DIEGO CA
92130-2053
US

V. Phone/Fax

Practice location:
  • Phone: 858-523-8365
  • Fax: 760-387-1803
Mailing address:
  • Phone: 858-523-8365
  • Fax: 760-387-1803

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA065800
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License NumberA065800
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: