Dr. Brent R Driskill
Otolaryngology

Address: 4033 3rd Ave Ste 104, San Diego, CA 92103-2136
Phone: 6192942350

Dr. Brent R Driskill (NPI# 1477612372) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider Identifier (NPI) 1477612372
Entity Type Individual
Full Name Dr. Brent R Driskill
Credential M.D.
Gender Male
Practice Address 4033 3rd Ave Ste 104
San Diego
CA 92103-2136
Practice Telephone 6192942350
Practice Fax Number 6192965719
Mailing Address 1656 Pennsylvania Ave
San Diego
CA 92103
Mailing Telephone 2028702090
Sole Proprietor No, this individual is not a Sole Proprietor
Enumeration Date 2006-12-06
Last Update Date 2019-05-24

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
Yes 207Y00000X Otolaryngology Allopathic & Osteopathic Physicians C146197 CA
No 207Y00000X Otolaryngology Allopathic & Osteopathic Physicians 0101240491 VA
No 207Y00000X Otolaryngology Allopathic & Osteopathic Physicians 036142067 IL

Physician Overview

NPI 1477612372
PAC ID by PECOS 0648402313
Professional Enrollment ID I20170630001454
Full Name Brent Ray Driskill
Gender M
Medical School UNIFORMED SERVICES UNIVERSITY OF THE HEALTH SCIENCES
Graduation Year 2005
Primary Specialty OTOLARYNGOLOGY
Accepts Medicare Assignment Y

Claims Based Hospital Affiliation

Claim Control Number (CCN) Legal Business Name
050100 SHARP MEMORIAL HOSPITAL

Taxonomy Information

Taxonomy Code 207Y00000X
Grouping Allopathic & Osteopathic Physicians
Classification Otolaryngology

Taxonomy Definition

An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1447663794 Daniel Dewerd Otolaryngology 3627 Riviera Dr, San Diego, CA 92109-6641 2014-06-04
1003239948 Jesse Qualliotine Otolaryngology 200 W Arbor Dr # 8895, San Diego, CA 92103 2014-01-29
1972931236 Joseph Traxler Otolaryngology 12356 Avenida Consentido, San Diego, CA 92128-3283 2013-10-24
1174963532 Ryan Anders Crane Otolaryngology Department of Otolaryngology - Nmc San Diego, 34800 Bob Wilson Dr, San Diego, CA 92134 2013-07-01
1225395734 Samantha Jill Hauff Otolaryngology 4282 Genesee Ave Ste 202, San Diego, CA 92117-4989 2012-04-20
1205064805 Art Anthony Ambrosio Otolaryngology 34800 Bob Wilson Dr Ste 200, San Diego, CA 92134-2538 2009-06-23
1376600601 Perry Mansfield, M.d., Inc. Otolaryngology 6645 Alvarado Rd # 4000, San Diego, CA 92120-5208 2007-01-03
1215005699 Angela M Powell Otolaryngology 34520 Bob Wilson Dr Ste 200, San Diego, CA 92134-2200 2006-12-01
1144320599 Marc E Kramer Otolaryngology 8929 University Center Lane, #208, San Diego, CA 92122 2006-09-25
1003825571 Sapideh Gilani Otolaryngology 200 W Arbor Dr # Mc8895, Division of Otolaryngology Ucsd, San Diego, CA 92103-1911 2006-08-05
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Office Location

Street Address 4033 3RD AVE STE 104
City SAN DIEGO
State CA
Zip Code 92103-2136

Providers in the same location

NPI Name Taxonomy Address Enumeration
1235798919 Brent R Driskill Md Inc Otolaryngology 4033 3rd Ave Ste 104, San Diego, CA 92103-2136 2019-06-06

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1174140057 Carmel Agdeppa Acupuncturist Chiropractique, 813 West Washington St., San Diego, CA 92103 2020-06-26
1568082717 Salina Ann Bambic Social Worker 302 Washington Street Suite 420, San Diego, CA 92103 2020-04-17
1467099432 Lina Hong Behavior Technician 3731 6th Ave. Suite 100, San Diego, Ca 92103, San Diego, CA 92103 2019-12-09
1154964567 Rodger Stacy Questin, Psychologist P.C. Psychologist 440 Upas St Apt 402, San Diego, CA 92103 2019-10-18
1932740388 Grace Tong-ventura Pharmacist 200 W. Arbor Drive, #8765, Suite 1-317, San Diego, CA 92103 2019-10-07
1306490453 Genevieve Cheung Pharmacist 200 W Arbor Dr #8765, Department of Pharmacy, San Diego, CA 92103 2019-07-26
1801356837 Marika Doviak Acupuncturist 2370 Hickory St, San Diego, CA 92103 2019-03-25
1982185070 Tyler Lewis Roberts Counselor 4303 3rd Ave, San Diego, CA 92103 2018-08-27
1689151284 Tori Breanne Blackwell Occupational Therapist 3731-a 6th Avenue, San Diego, CA 92103 2018-07-26
1952892614 Pacific Bay Recovery Inc Substance Abuse Rehabilitation Facility 4095 Jackdaw St, San Diego, CA 92103 2018-05-29
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City SAN DIEGO
Zip Code 92103

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.