Provider Demographics
NPI:1871990838
Name:BRIZZIE MEDICAL INC
Entity type:Organization
Organization Name:BRIZZIE MEDICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RON
Authorized Official - Middle Name:BERKLEY
Authorized Official - Last Name:BRIZZIE
Authorized Official - Suffix:II
Authorized Official - Credentials:DO
Authorized Official - Phone:760-757-0222
Mailing Address - Street 1:2741 VISTA WAY
Mailing Address - Street 2:SUITE 201
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92054-9011
Mailing Address - Country:US
Mailing Address - Phone:760-757-0222
Mailing Address - Fax:760-754-5428
Practice Address - Street 1:2741 VISTA WAY
Practice Address - Street 2:SUITE 201
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92054-9011
Practice Address - Country:US
Practice Address - Phone:760-757-0222
Practice Address - Fax:760-754-5428
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-19
Last Update Date:2014-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty