Individual
BRYAN BISANZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 W ARBOR DR, SAN DIEGO, CA 92103-9000
(619) 543-6222
Mailing address
1237 PENNSYLVANIA AVE APT 6, SAN DIEGO, CA 92103-4430
(847) 412-8273
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
A164688
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/09/2018
Last updated
11/16/2021
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