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Individual

DR. BRENT JAMES MICHAEL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2001 SANTA MONICA BLVD STE 470W, SANTA MONICA, CA 90404-2181
(310) 829-7777
(310) 829-9951
Mailing address
2001 SANTA MONICA BLVD STE 470W, SANTA MONICA, CA 90404-2181
(310) 829-7777
(310) 829-9951

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A81591
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0018000940001
ONE HEALTH PLAN
01
00A815910
BLUE SHIELD HMO
01
0EL054
BLUE CROSS OF CA
01
105958
HEALTH NET
01
11672120
PACIFICCARE
01
7410555
AETNA
01
906487
CIGNA
01
QX0297
SR
Enumeration date
12/22/2006
Last updated
05/14/2021
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