Individual
DR. BRIAN I WATANABE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
24953 PASEO DE VALENCIA, SUITE 15C, LAGUNA HILLS, CA 92653-4342
(949) 770-9300
(949) 770-9310
Mailing address
24953 PASEO DE VALENCIA, SUITE 15C, LAGUNA HILLS, CA 92653-4342
(949) 770-9300
(949) 770-9310
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
G83423
CA
2086S0129X
Vascular Surgery Physician
Primary
G83423
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1417286980
CORPORATION NPI
CA
01
—
CS338Y
MEDICARE PTAN
—
Enumeration date
11/15/2006
Last updated
04/08/2013
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