Organization Name: | GARY BRAZINA MD, INC. |
NPI Number: | 1992942254 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | GARY E BRAZINA (PRESIDENT/OWNER) |
Mailing Address: | 13160 Mindanao Way Ste 300 Marina Del Rey |
State: | CA US |
Postal Code: | 902926393 |
Phone Number: | 3108212222 |
Fax Number: | 3108235871 |
NPI Enumeration Date: | 01/08/2009 |
NPI Last Update Date: | 01/08/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | G37830 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |