Provider Demographics
NPI:1801896311
Name:BRION, PETER LU (MD)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:LU
Last Name:BRION
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 SULLIVAN AVE
Mailing Address - Street 2:SUITE 605
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94015-2228
Mailing Address - Country:US
Mailing Address - Phone:650-992-8456
Mailing Address - Fax:650-992-8356
Practice Address - Street 1:1800 SULLIVAN AVE
Practice Address - Street 2:SUITE 605
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94015-2228
Practice Address - Country:US
Practice Address - Phone:650-992-8456
Practice Address - Fax:650-992-8356
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-26
Last Update Date:2011-08-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA53147207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A531470Medicaid
CA00A531470Medicare ID - Type Unspecified
CAG63077Medicare UPIN