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General NPI Number Information
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NPI Number | 1427084854
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Entity Type | Organization
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Legal Business Name | A. JAMES BEHREND MD MEDICAL CORPORATION
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Dates
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Enumeration Date | 06/25/2006
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Last Update Date | 06/22/2010
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Provider Practice Location Address
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Address Line | 450 STABLERIDGE ST
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City | EL CAJON
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State | CA
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Zip | 92019-1245
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Country | US
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Telephone | 619-462-5916
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Fax | 619-334-1313
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Provider Business Mailing Address
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Address Line | PO BOX 2005
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City | EL CAJON
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State | CA
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Zip | 92021-0005
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Country | US
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Telephone | 619-462-5916
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Fax | 619-334-1313
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Authorized Official
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Title or Position | PRESIDENT
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Name | ALBERT JAMES BEHREND
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Credential | M.D.
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Telephone | 619-462-5916
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | C40277
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | C40277
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License Number State | CA
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