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General NPI Number Information
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NPI Number | 1790780484
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Entity Type | Individual
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Provider Name | TERRY L. BEHREND M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/17/2005
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Last Update Date | 02/02/2021
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Provider Practice Location Address
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Address Line | 7910 FROST ST STE 220
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City | SAN DIEGO
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State | CA
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Zip | 92123-2781
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Country | US
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Telephone | 858-637-4700
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Fax | 858-637-4701
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Provider Business Mailing Address
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Address Line | 4225 EXECUTIVE SQ STE 450
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City | LA JOLLA
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State | CA
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Zip | 92037-8411
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Country | US
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Telephone | 858-810-0000
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Fax | 858-268-1911
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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 | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | A75812
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License Number State | CA
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