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General NPI Number Information
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NPI Number | 1184253494
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Entity Type | Individual
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Provider Name | BRAD J EIGEN BSN, MSN FNP
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Gender | Male
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Dates
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Enumeration Date | 04/07/2020
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Last Update Date | 04/07/2020
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Provider Practice Location Address
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Address Line | 359 BEL MARIN KEYS BLVD
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City | NOVATO
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State | CA
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Zip | 94949-5653
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Country | US
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Telephone | 415-287-0700
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Fax |
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Provider Business Mailing Address
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Address Line | 877 LONGRIDGE RD
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City | OAKLAND
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State | CA
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Zip | 94610-2451
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Country | US
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Telephone | 510-508-0788
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | NP95014278
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | NP95014278
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | NP95014278
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | NP95014278
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License Number State | CA
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