Individual
BRIAN KENJI SUGIMOTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3393 G ST STE C, MERCED, CA 95340-1001
(209) 580-4172
(209) 233-9859
Mailing address
PO BOX 3768, MERCED, CA 95344-3768
(209) 723-3704
(209) 723-0272
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
G80308
CA
207Q00000X
Family Medicine Physician
Primary
G80308
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G803080
—
CA
Enumeration date
06/28/2006
Last updated
12/10/2020
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