Individual
STANLEY D. BRIZENDINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2030 COFFEE RD, SUITE A-1, MODESTO, CA 95355-2413
(209) 578-0443
(209) 578-5933
Mailing address
3050 E AIRPORT WAY, LONG BEACH, CA 90806-2404
(562) 426-9661
(562) 426-4227
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
842
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN3342680
MEDI-CAL
CA
Enumeration date
09/27/2006
Last updated
07/08/2007
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