MEDICARE: DR. RONALD D BRIX 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	207P00000X	Emergency Medicine Physician	G47024	CA

General Provider Information

NPI Number	:	1407971427
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RONALD D BRIX M.D.

Provider Business Mailing Address
First Line	:	53673 MOIC DR
Second Line	:
City	:	NORTH FORK
State	:	CA
Zip	:	93643-9794
Country	:	US
Telephone Number	:	559-970-6943
Fax Number	:

Provider Business Practice Location Address
First Line	:	53673 MOIC DR
Second Line	:
City	:	NORTH FORK
State	:	CA
Zip	:	93643-9794
Country	:	US
Telephone Number	:	559-970-6943
Fax Number	:

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

Provider Enumeration Date	:	03/20/2007
Last Update Date	:	02/23/2012

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