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General NPI Number Information
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NPI Number | 1245300649
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Entity Type | Organization
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Legal Business Name | BRIAN K GAMBLE, M.D. INC.
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Dates
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Enumeration Date | 11/09/2006
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Last Update Date | 12/12/2008
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Provider Practice Location Address
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Address Line | 3460 WILSHIRE BLVD STE 1000
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City | LOS ANGELES
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State | CA
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Zip | 90010-2206
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Country | US
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Telephone | 213-487-3845
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Fax | 213-487-6259
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Provider Business Mailing Address
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Address Line | 3460 WILSHIRE BLVD STE 1000
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City | LOS ANGELES
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State | CA
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Zip | 90010-2206
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Country | US
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Telephone | 213-487-3845
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Fax | 213-487-6259
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Authorized Official
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Title or Position | PRESIDENT
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Name | BRIAN K GAMBLE
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Credential |
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Telephone | 213-487-3845
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | A76121
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License Number State | CA
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