Individual
DR. BREHAN LARA KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
428 S GILBERT RD STE 115, GILBERT, AZ 85296-2262
(480) 507-2961
(480) 507-2971
Mailing address
PO BOX 1847, GILBERT, AZ 85299-1847
(480) 507-2961
(480) 507-2971
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
37944
AZ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
356711
—
AZ
01
—
P00692519
MEDICARE RR
AZ
Enumeration date
05/24/2007
Last updated
03/07/2023
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