Basic Information
Provider Information
NPI: 1104888544
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PARTRIDGE
FirstName: BRETT
MiddleName: J.
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: NAVAL MEDICAL CENTER SAN DIEGO
Address2: 34800 BOB WILSON DRIVE
City: SAN DIEGO
State: CA
PostalCode: 921340001
CountryCode: US
TelephoneNumber: 6195326400
FaxNumber:  
Practice Location
Address1: NAVAL MEDICAL CENTER SAN DIEGO
Address2: 34800 BOB WILSON DRIVE
City: SAN DIEGO
State: CA
PostalCode: 921340001
CountryCode: US
TelephoneNumber: 6195326400
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/03/2006
LastUpdateDate: 12/03/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XMD436400PAN Allopathic & Osteopathic PhysiciansInternal Medicine 
207RG0100XMD436400PAY Allopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
207R00000X01057964AINN Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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