Individual
ANTONE BRISENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
116 WEST MINNESOTA AVE, MCCLOUD, CA 96057-1143
(530) 964-2389
(530) 964-3141
Mailing address
75-5751 KUAKINI HWY, STE 203, KAILUA KONA, HI 96740-1753
(808) 326-3891
(808) 329-9370
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA17420
CA
Other
Enumeration date
09/17/2007
Last updated
08/10/2017
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