Burt Brent MD a Medical Corporation

Organization Active NPI Plastic and Reconstructive Surgery Physician · Woodside, CA

NPI 1184763476 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1184763476
Entity type
Organization (NPI type 2)
Primary specialty
Plastic and Reconstructive Surgery Physician 2086S0122X
License
G26091 (CA)
Legal business name
BURT BRENT MD A MEDICAL CORPORATION
Practice address
2995 Woodside Road
Suite 300
Woodside, CA 94062-2447
Phone
(650) 851-5300
Fax
(650) 851-5302
NPI assigned
Feb 5, 2007
Organization subpart
No

Authorized official

Name
Dr. Burton D Brent, MD
Title
Physician Owner
Phone
(650) 851-5300

National Provider Directory

Locations

2995 Woodside Rd
Ste 300
Woodside, CA 94062
Phone (650) 275-2326

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery Physician
Group: 193400000X SINGLE SPECIALTY GROUP
2086S0122X G26091 CA Yes

Addresses

Primary practice location

2995 Woodside Road
Suite 300
Woodside, CA 94062-2447

Mailing address

2995 Woodside Road
Suite 300
Woodside, CA 94062-2447
Phone (650) 851-5300

Other identifiers

IdentifierTypeStateIssuer
00G260910MedicaidCA

Other names

  • Burton D Brent MD Former legal business name

Other providers in Woodside, CA

All providers in Woodside, CA · Plastic and Reconstructive Surgery Physician in California

Sources for this page

Verify at the official NPI Registry.