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Organization
BRIAN K. ESTWICK, M.D., INC.
Active
Organization
BRIAN K. ESTWICK, M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN KEITH ESTWICK M.D. (MEDICAL DIRECTOR)
(310) 390-2420
Entity
Organization
Contact information
Practice address
4644 LINCOLN BLVD, SUITE 430, MARINA DEL REY, CA 90292-6313
(310) 390-2420
(310) 392-2364
Mailing address
2640 29TH ST, SANTA MONICA, CA 90405-2916
(310) 568-8579
(310) 450-9368
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
A41775
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A417750
—
CA
01
—
1003889247
PERSONAL NPI
CA
Enumeration date
02/01/2007
Last updated
07/12/2011
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