Individual
DR. BRIAN RANDALL GANTWERKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2811 WILSHIRE BLVD, SUITE 840, SANTA MONICA, CA 90403-4803
(310) 694-8300
(310) 694-8357
Mailing address
PO BOX 492209, LOS ANGELES, CA 90049-2209
(310) 694-8300
(310) 694-8357
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
A109316
CA
Other
Enumeration date
02/28/2006
Last updated
06/14/2016
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