# BRIAN K. ESTWICK, M.D., INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003953530
- **Authorized official:** DR. BRIAN KEITH ESTWICK M.D. (MEDICAL DIRECTOR)
- **Authorized official phone:** (310) 390-2420

## Contact information

- **Practice address:** 4644 LINCOLN BLVD, SUITE 430, MARINA DEL REY, CA 90292-6313
- **Practice address phone:** (310) 390-2420
- **Practice address fax:** (310) 392-2364
- **Mailing address:** 2640 29TH ST, SANTA MONICA, CA 90405-2916
- **Mailing address phone:** (310) 568-8579
- **Mailing address fax:** (310) 450-9368

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | A41775 | CA | Yes |

## Other

- **Enumeration date:** 02/01/2007
- **Last updated:** 07/12/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00A417750 | — | CA |
| 01 | — | 1003889247 | PERSONAL NPI | CA |