MEDICARE: SUSAN BRIONES MD

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	207Q00000X	Family Medicine Physician	22101	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1275684284
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN BRIONES MD

Provider Business Mailing Address
First Line	:	1455 W CHANDLER BLVD
Second Line	:	STE. B-11
City	:	CHANDLER
State	:	AZ
Zip	:	85224-6177
Country	:	US
Telephone Number	:	480-917-9208
Fax Number	:	480-814-7443

Provider Business Practice Location Address
First Line	:	1455 W CHANDLER BLVD
Second Line	:	STE. B-11
City	:	CHANDLER
State	:	AZ
Zip	:	85224-6177
Country	:	US
Telephone Number	:	480-917-9208
Fax Number	:	480-814-7443

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

Provider Enumeration Date	:	01/16/2007
Last Update Date	:	10/20/2015

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Directions to “ SUSAN BRIONES MD” Practice Location

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