Individual
BRENT LINDEN FOGEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
300 MEDICAL PLAZA SUITE B200, LOS ANGELES, CA 90095
(310) 794-1195
(310) 794-7491
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
A90493
CA
2084P0005X
Neurodevelopmental Disabilities Physician
A90493
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A904930
—
CA
Enumeration date
05/25/2007
Last updated
01/16/2020
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