Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | G42126 | CA |
NPI | 1336123561 |
---|---|
Provider Name | Dr. Brian Stephen Orisek |
First Address | San Jose, CA 95124-4006 |
Second Address | San Jose, CA 95124-4006 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/12/2005 |
Last Update Date | 08/07/2007 |