Individual
BRIAN CRAIG PRIDGEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
770 WELCH RD, SUITE 400, PALO ALTO, CA 94304-1511
(111) 111-1111
Mailing address
770 WELCH RD, SUITE 400, PALO ALTO, CA 94304-1511
(111) 111-1111
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
A127478
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/10/2012
Last updated
12/03/2020
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