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Individual

BARRY LEE BRISCO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CNIM, R.EEG T.

Contact information

Practice address
450 STANYAN ST, SAN FRANCISCO, CA 94117-1019
(800) 305-6234
Mailing address
1547 TARRYTOWN ST, SAN MATEO, CA 94402-3821
(650) 346-6342

Taxonomy

Speciality
Code
Description
License number
State
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1126
R.EEG T.
01
2099
CNIM
Enumeration date
02/23/2011
Last updated
07/22/2015
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