Healthcare Provider Details

I. General information

NPI: 1992744148
Provider Name (Legal Business Name): ARTHUR L. BRODY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2006
Last Update Date: 05/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 UCLA MEDICAL PLZ
LOS ANGELES CA
90095-8346
US

IV. Provider business mailing address

300 UCLA MEDICAL PLZ
LOS ANGELES CA
90095-8346
US

V. Phone/Fax

Practice location:
  • Phone: 310-268-4401
  • Fax:
Mailing address:
  • Phone: 310-268-4401
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License NumberG72625
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: