Healthcare Provider Details
I. General information
NPI: 1306422308
Provider Name (Legal Business Name): BRANDON KENNETH FIELDS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/20/2021
Last Update Date: 03/05/2026
Certification Date: 03/05/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
505 PARNASSUS AVE
SAN FRANCISCO CA
94143-2204
US
IV. Provider business mailing address
513 PARNASSUS AVE RM S257A, BOX 0628, SLOT 28
SAN FRANCISCO CA
94143-2205
US
V. Phone/Fax
- Phone: 415-353-2887
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | A179873 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: