Provider Demographics
NPI:1902234651
Name:BELLO, BRIAN STEVEN (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:STEVEN
Last Name:BELLO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4966 EL CAMINO REAL
Mailing Address - Street 2:STE 224
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94022-1458
Mailing Address - Country:US
Mailing Address - Phone:650-690-2362
Mailing Address - Fax:650-590-4938
Practice Address - Street 1:1200 N STATE ST
Practice Address - Street 2:CLINIC TOWER A7D
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033-1029
Practice Address - Country:US
Practice Address - Phone:323-226-5555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-16
Last Update Date:2019-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1274972084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry