Brunel Bredy, MD
Individual provider Active NPI Family Medicine Physician · King City, CA
NPI 1407925860 · NPPES record last updated Jan 17, 2022
Key facts
- NPI
- 1407925860
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- A75486 (CA)
- Practice address
- 122 San Antonio Drive
King City, CA 93930-2942 - Phone
- (831) 385-5944
- Fax
- (831) 385-8618
- NPI assigned
- Nov 7, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 3
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Georgetown University School of Medicine, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Permanente Medical Group Inc
Practice addresses (Care Compare)
7373 W Lane
Stockton, CA 95210-3377
Phone (209) 476-2000
Hospital & facility affiliations
- Kaiser Foundation Hosp So Sacramento
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070413000208 | CA | Practitioner - Family Practice | 7911002332 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 75486 | CA | MD | Pharmacist |
| A75486 | CA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Permanente Medical Group, Inc | Current |
Accepting new patients | |
| Permanente Medical Group Inc | Family Medicine | Current |
Accepting new patients |
Locations
9201 Big Horn Blvd
Elk Grove, CA 95758
Phone (916) 478-5000
1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015
901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500
2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000
710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400
7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000
975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | A75486 | CA | Yes |
Addresses
Primary practice location
122 San Antonio Drive
King City, CA 93930-2942
Mailing address
122 San Antonio Drive
King City, CA 93930-2942
Phone (831) 385-5944
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RHM53997F | Medicaid | CA | |
| GR011110 | Medicaid | CA |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq | Health Information Exchange (HIE) |
Other providers in King City, CA
- Amber Sarina Rdhap
- Beatriz Argueta
- Christopher Donald Ash
- Aura Counseling Inc.
- Anna Laura Barragan
- Erin Elizabeth Bulleit
- California Em-I Medical Services, a Medical Corporation
- Camelia C Wogu MD LTD
- Jeffrey Campbell
- Mariana Vera Casillas
All providers in King City, CA · Family Medicine Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 17, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.