Individual
MR. BRENT ELI MCCLOUD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
333 S BEAUDRY AVE, LOS ANGELES, CA 90017-1466
(213) 241-3841
(213) 241-3305
Mailing address
333 S BEAUDRY AVE, LOS ANGELES, CA 90017-1466
(213) 241-3841
(213) 241-3305
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
225400000X
Rehabilitation Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1265781926
VISTA DEL MAR
CA
Enumeration date
09/09/2012
Last updated
06/14/2023
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