Provider Demographics
NPI:1699574459
Name:BURLINGAME GASTROENTEROLOGY AND HEPATOLOGY
Entity type:Organization
Organization Name:BURLINGAME GASTROENTEROLOGY AND HEPATOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NERISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRANDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-342-6506
Mailing Address - Street 1:1720 EL CAMINO REAL STE 155
Mailing Address - Street 2:
Mailing Address - City:BURLINGAME
Mailing Address - State:CA
Mailing Address - Zip Code:94010-3231
Mailing Address - Country:US
Mailing Address - Phone:650-342-6506
Mailing Address - Fax:650-340-9032
Practice Address - Street 1:1720 EL CAMINO REAL STE 155
Practice Address - Street 2:
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-3231
Practice Address - Country:US
Practice Address - Phone:650-342-6506
Practice Address - Fax:650-340-9032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-12
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty