Organization
BRIAN D. BRANTNER, M.D. A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN D. BRANTNER M.D. (PRESIDENT)
(805) 653-6765
Entity
Organization
Contact information
Practice address
3555 LOMA VISTA RD, SUITE 200, VENTURA, CA 93003-3161
(805) 653-6765
(805) 653-1470
Mailing address
3555 LOMA VISTA RD, SUITE 200, VENTURA, CA 93003-3161
(805) 653-6765
(805) 653-1470
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
G027037
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G02-7037
MEDICARE ID- TYPE UNSPECIFIRED
CA
Enumeration date
01/24/2008
Last updated
07/14/2011
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