Healthcare Provider Details

I. General information

NPI: 1053513432
Provider Name (Legal Business Name): DAVID E BRESLER PHD, LAC, DIPLAC,
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2007
Last Update Date: 07/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 THAYER AVE UNIT A
LOS ANGELES CA
90025-6180
US

IV. Provider business mailing address

30765 PACIFIC COAST HWY SUITE 355
MALIBU CA
90265-3646
US

V. Phone/Fax

Practice location:
  • Phone: 310-474-2777
  • Fax: 310-474-2777
Mailing address:
  • Phone: 310-474-2777
  • Fax: 310-474-2777

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TH0004X
TaxonomyHealth Psychologist
License NumberPSY4685
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC126
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: