Organization
BRIAN K GAMBLE, M.D. INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN KEITH GAMBLE M.D. (C.E.O.)
(818) 786-5360
Entity
Organization
Contact information
Practice address
13521 SHERMAN WAY, UNIT D, VAN NUYS, CA 91405-2894
(818) 786-5360
(818) 786-5670
Mailing address
13521 SHERMAN WAY, UNIT D, VAN NUYS, CA 91405-2894
(818) 786-5360
(818) 786-5670
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
W20244A
CA
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
A76121
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A76121
STATE LICENSE
CA
Enumeration date
06/12/2007
Last updated
01/23/2008
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