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NPI Code Detail

MEDICARE: DR. GREGORY SCOTT BREWSTER M.D.

MEDICARE: DR. GREGORY SCOTT BREWSTER 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
1207P00000XEmergency Medicine PhysicianA61173CA
2207PE0004XEmergency Medical Services (Emergency Medicine) PhysicianA61173CA

Other Identifiers

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

General Provider Information

NPI Number : 1639164007
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GREGORY SCOTT BREWSTER M.D.
Provider Business Mailing Address
First Line : PO BOX 661748
Second Line :
City : ARCADIA
State : CA
Zip : 91066-1748
Country : US
Telephone Number : 626-447-0296
Fax Number : 626-447-6057
Provider Business Practice Location Address
First Line : 111 N SEPULVEDA BLVD STE 210
Second Line :
City : MANHATTAN BEACH
State : CA
Zip : 90266-6849
Country : US
Telephone Number : 310-379-2134
Fax Number : 310-379-4856
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/13/2005
Last Update Date : 08/13/2012

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