Basic Information
Provider Information
NPI: 1699751255
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PITTS
FirstName: BRIAN
MiddleName: L.
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4150 V ST
Address2: PSSB-SUITE 1200 - MED: ANESTHESIA
City: SACRAMENTO
State: CA
PostalCode: 958171460
CountryCode: US
TelephoneNumber: 9167347985
FaxNumber: 9167342975
Practice Location
Address1: 4150 V ST
Address2: PSSB-SUITE 1200 - MED: ANESTHESIA
City: SACRAMENTO
State: CA
PostalCode: 958171460
CountryCode: US
TelephoneNumber: 9167347985
FaxNumber: 9167342975
Other Information
ProviderEnumerationDate: 12/15/2005
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: X
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000XA828160CAY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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