Provider Demographics
NPI:1043565591
Name:BRAZIE'R, JAME'E WILEY (LAC DAOM)
Entity type:Individual
Prefix:DR
First Name:JAME'E
Middle Name:WILEY
Last Name:BRAZIE'R
Suffix:
Gender:M
Credentials:LAC DAOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:215 N SAN MATEO DR STE 2
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94401-2674
Mailing Address - Country:US
Mailing Address - Phone:650-980-5088
Mailing Address - Fax:800-886-4813
Practice Address - Street 1:215 N SAN MATEO DR STE 2
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94401-2674
Practice Address - Country:US
Practice Address - Phone:650-980-5088
Practice Address - Fax:800-886-4813
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-20
Last Update Date:2019-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA117797171100000X
CAAC14050171100000X
CAAC 140502083P0901X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice