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General NPI Number Information
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NPI Number | 1215100383
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Entity Type | Individual
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Provider Name | RICHARD WILLIAM BRENNER MD
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Gender | Male
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Dates
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Enumeration Date | 04/09/2008
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Last Update Date | 04/09/2008
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Provider Practice Location Address
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Address Line | 980 MAGNOLIA AVE STE 8
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City | LARKSPUR
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State | CA
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Zip | 94939
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Country | US
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Telephone | 415-927-2767
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Fax | 415-461-4626
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Provider Business Mailing Address
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Address Line | PO BOX 5095
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City | LARKSPUR
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State | CA
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Zip | 94977-5095
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Country | US
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Telephone | 415-927-2765
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Fax | 415-461-4626
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | G8796
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License Number State | CA
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