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General NPI Number Information
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NPI Number | 1427175082
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Entity Type | Organization
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Legal Business Name | MINKUS FAMILY MEDICINE A MEDICAL CORPORATION
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 11/19/2015
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Provider Practice Location Address
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Address Line | 18502 GRIDLEY ROAD
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City | ARTESIA
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State | CA
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Zip | 90701-5436
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Country | US
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Telephone | 562-865-6160
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Fax | 562-468-4315
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Provider Business Mailing Address
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Address Line | 18502 GRIDLEY ROAD
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City | ARTESIA
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State | CA
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Zip | 90701-5436
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Country | US
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Telephone | 562-865-6160
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Fax | 562-468-4315
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Authorized Official
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Title or Position | FAMILY PRACTICE
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Name | DR. BRIAN LEE MINKUS
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Credential | D.O.
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Telephone | 562-865-6160
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 20A5897
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License Number State | CA
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