MEDICARE: DR. BRETT D BRIMHALL M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	AFE74164	CA

General Provider Information

NPI Number	:	1033191853
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRETT D BRIMHALL M.D.

Provider Business Mailing Address
First Line	:	6850 N DURANGO DR
Second Line	:	110
City	:	LAS VEGAS
State	:	NV
Zip	:	89149-4595
Country	:	US
Telephone Number	:	702-263-2020
Fax Number	:	702-396-0287

Provider Business Practice Location Address
First Line	:	6850 N DURANGO DR
Second Line	:	110
City	:	LAS VEGAS
State	:	NV
Zip	:	89149-4595
Country	:	US
Telephone Number	:	702-263-2020
Fax Number	:	702-396-0287

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/17/2005
Last Update Date	:	03/07/2017

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