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General NPI Number Information
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NPI Number | 1255361432
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Entity Type | Organization
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Legal Business Name | H. GEORGE BRENNAN, M.D., INC.
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Dates
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Enumeration Date | 07/04/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 400 NEWPORT CENTER DR STE. 100
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-7601
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Country | US
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Telephone | 949-644-1641
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Fax |
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Provider Business Mailing Address
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Address Line | 11999 SAN VICENTE BLVD STE. 440
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City | LOS ANGELES
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State | CA
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Zip | 90049-5131
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Country | US
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Telephone | 310-440-3131
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Fax | 310-472-9582
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Authorized Official
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Title or Position | OWNER
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Name | DR. H. GEORGE BRENNAN
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Credential | M.D.
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Telephone | 949-644-1641
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207YX0905X
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Taxonomy Name | Otolaryngology/Facial Plastic Surgery Physician
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License Number | C27484
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License Number State | CA
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