Healthcare Provider Details

I. General information

NPI: 1033132048
Provider Name (Legal Business Name): BREALL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 03/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2250 HAYES ST SUITE 204
SAN FRANCISCO CA
94117-1078
US

IV. Provider business mailing address

2250 HAYES ST SUITE 204
SAN FRANCISCO CA
94117-1078
US

V. Phone/Fax

Practice location:
  • Phone: 415-933-9100
  • Fax: 415-933-9133
Mailing address:
  • Phone: 415-933-9100
  • Fax: 415-933-9133

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: SHEILA BILLINGS
Title or Position: OFFICE MANAGER
Credential:
Phone: 415-933-9100