Individual
NANETTE DENISE DEBRUHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
200 UCLA MEDICAL PLZ STE B165, LOS ANGELES, CA 90095-3075
(310) 301-6800
(310) 794-9035
Mailing address
5767 W CENTURY BLVD, SUITE 400, LOS ANGELES, CA 90045-5631
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
G66392
CA
2086X0206X
Surgical Oncology Physician
G66392
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G663920
—
CA
Enumeration date
05/12/2006
Last updated
12/11/2019
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