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General NPI Number Information
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NPI Number | 1245123124
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Entity Type | Organization
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Legal Business Name | BREAUX MEDICAL, PC
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Dates
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Enumeration Date | 05/30/2025
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Last Update Date | 05/30/2025
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Provider Practice Location Address
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Address Line | 5960 MCANDREW DR
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City | OAKLAND
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State | CA
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Zip | 94611-3135
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Country | US
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Telephone | 510-384-2846
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Fax | 510-279-3584
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Provider Business Mailing Address
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Address Line | 5960 MCANDREW DR
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City | OAKLAND
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State | CA
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Zip | 94611-3135
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Country | US
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Telephone | 510-384-2846
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CEO/FOUNDER
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Name | DR. BARRY ELLISON BREAUX JR.
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Credential | MD, MBA
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Telephone | 510-384-2846
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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