Provider Demographics
NPI:1992960405
Name:FURST, BRYAN (MD)
Entity type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:
Last Name:FURST
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:114 MISSION RANCH BLVD
Mailing Address - Street 2:SUITE 10
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-5137
Mailing Address - Country:US
Mailing Address - Phone:530-894-0500
Mailing Address - Fax:530-345-2532
Practice Address - Street 1:114 MISSION RANCH BLVD
Practice Address - Street 2:SUITE 10
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-5137
Practice Address - Country:US
Practice Address - Phone:530-894-0500
Practice Address - Fax:530-345-2532
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-23
Last Update Date:2012-03-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA116273207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFE552AMedicare PIN