Healthcare Provider Details

I. General information

NPI: 1861617268
Provider Name (Legal Business Name): SETH LOUIS BRINDIS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 W CARSON ST HARBOR UCLA MEDICAL CENTER, BOX17
TORRANCE CA
90509
US

IV. Provider business mailing address

1000 W CARSON ST HARBOR UCLA MEDICAL CENTER, BOX17
TORRANCE CA
90509
US

V. Phone/Fax

Practice location:
  • Phone: 310-222-2301
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA94150
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: