MEDICARE: DR. SALVADOR A. BRAU M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2086S0129X	Vascular Surgery Physician	G33964	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255491221
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SALVADOR A. BRAU M.D.

Provider Business Mailing Address
First Line	:	1334 WESTWOOD BLVD
Second Line	:	SUITE 1D
City	:	LOS ANGELES
State	:	CA
Zip	:	90024-4951
Country	:	US
Telephone Number	:	310-470-9911
Fax Number	:	310-470-2295

Provider Business Practice Location Address
First Line	:	1334 WESTWOOD BLVD
Second Line	:	SUITE 1D
City	:	LOS ANGELES
State	:	CA
Zip	:	90024-4951
Country	:	US
Telephone Number	:	310-470-9911
Fax Number	:	310-470-2295

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/11/2006
Last Update Date	:	07/09/2007

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