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Individual

BRETT MICHAEL ELICKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1001 POTRERO AVE, RM 1X55, SAN FRANCISCO, CA 94110-3518
(415) 206-5871
(415) 206-4004
Mailing address
PO BOX 7464, SAN FRANCISCO, CA 94120-7464
(415) 206-3103
(415) 206-3872

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
A91048
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00A910480
CA
Enumeration date
05/18/2006
Last updated
08/13/2012
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