Individual
ANTHONY CONRADO BRISENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5121 STOCKDALE HWY STE 275, BAKERSFIELD, CA 93309-2667
(661) 868-5000
Mailing address
5121 STOCKDALE HWY STE 275, BAKERSFIELD, CA 93309-2667
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
999034365
—
CA
Enumeration date
08/07/2018
Last updated
08/07/2018
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