Individual
DR. BRIAN J SUPPLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1000 NEWBURY RD STE 285, NEWBURY PARK, CA 91320-6445
(805) 499-7971
(805) 498-4192
Mailing address
1000 NEWBURY RD STE 285, NEWBURY PARK, CA 91320-6445
(805) 499-7971
(805) 498-4192
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
AO69956
CA
Other
Enumeration date
03/05/2007
Last updated
07/21/2022
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