Healthcare Provider Details

I. General information

NPI: 1245339340
Provider Name (Legal Business Name): SHARI ANNE BRAZINSKY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 04/17/2023
Certification Date: 04/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3110 CAMINO DEL RIO S
SAN DIEGO CA
92108-3812
US

IV. Provider business mailing address

PO BOX 1009
SPRING VALLEY CA
91979-1009
US

V. Phone/Fax

Practice location:
  • Phone: 619-400-5000
  • Fax:
Mailing address:
  • Phone: 619-508-0908
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberG70525A
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberG70525A
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: