Individual
BRIAN CHRISTOPHER VASSALO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1528 WOOLSEY ST APT D, BERKELEY, CA 94703-2353
(510) 999-2728
Mailing address
1528 WOOLSEY ST APT D, BERKELEY, CA 94703-2353
(510) 999-2728
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
95010119
CA
Other
Enumeration date
09/27/2018
Last updated
09/27/2018
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