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General NPI Number Information
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NPI Number | 1609335660
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Entity Type | Organization
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Legal Business Name | BRIGHTSIDE MEDICAL, P.A.
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Dates
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Enumeration Date | 03/18/2019
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Last Update Date | 11/18/2024
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Provider Practice Location Address
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Address Line | 5214F DIAMOND HEIGHTS BLVD # 345
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City | SAN FRANCISCO
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State | CA
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Zip | 94131-2175
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Country | US
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Telephone | 415-360-3348
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Fax |
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Provider Business Mailing Address
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Address Line | 2261 MARKET ST STE 10222
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City | SAN FRANCISCO
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State | CA
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Zip | 94114-1612
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Country | US
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Telephone | 415-360-3348
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Fax | 855-350-5708
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MIRENE WINSBERG
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Credential |
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Telephone | 415-360-3348
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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 |
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License Number State |
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