Healthcare Provider Details

I. General information

NPI: 1528283249
Provider Name (Legal Business Name): BRETT ANDREW GIDNEY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/16/2007
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1304 ELLA ST STE A
SAN LUIS OBISPO CA
93401-4165
US

IV. Provider business mailing address

1304 ELLA ST STE A
SAN LUIS OBISPO CA
93401-4165
US

V. Phone/Fax

Practice location:
  • Phone: 805-549-9555
  • Fax: 805-549-0444
Mailing address:
  • Phone: 805-549-9555
  • Fax: 805-549-0444

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberA81336
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: