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Organization

PREMIER CARE PROVIDERS, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BRIAN EARL BRISTOL NURSE PRACTITIONER (NURSE PRACTICIONER)
(310) 795-7528
Entity
Organization

Contact information

Practice address
7219 VAN NUYS BLVD, VAN NUYS, CA 91405-2256
(818) 855-1400
(818) 846-8559
Mailing address
7219 VAN NUYS BLVD, VAN NUYS, CA 91405-2256
(818) 855-1400

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
261QP2300X
Primary Care Clinic/Center
363LP2300X
Primary Care Nurse Practitioner
Primary

Other

Enumeration date
02/13/2025
Last updated
02/13/2025
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