Individual
DR. BRIAN M. TYSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2026 N IMPERIAL AVE STE C, EL CENTRO, CA 92243-1607
(760) 592-4351
Mailing address
420 SUNFLOWER CT, BRAWLEY, CA 92227-3243
(760) 592-4351
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A88297
CA
208M00000X
Hospitalist Physician
A88297
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A882970
BLUE SHIELD
CA
Enumeration date
07/14/2006
Last updated
03/03/2022
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