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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