Provider Demographics
NPI:1497866495
Name:BREIHAN, LAUREN GAIL (MD)
Entity type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:GAIL
Last Name:BREIHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3480 E ROUTE 66
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86004-4032
Mailing Address - Country:US
Mailing Address - Phone:928-863-7333
Mailing Address - Fax:928-863-7347
Practice Address - Street 1:3480 E. ROUTE 66
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86004
Practice Address - Country:US
Practice Address - Phone:928-863-7333
Practice Address - Fax:928-863-7347
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2023-03-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ23601207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZBB4659009OtherDEA #
AZG21192Medicare UPIN