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General NPI Number Information
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NPI Number | 1528546264
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Entity Type | Organization
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Legal Business Name | JEFFREY BRUMBAUGH, DDS, MS, INC.
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Dates
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Enumeration Date | 08/03/2018
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Last Update Date | 08/03/2018
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Provider Practice Location Address
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Address Line | 12121 WILSHIRE BLVD STE 1111
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City | LOS ANGELES
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State | CA
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Zip | 90025-1188
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Country | US
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Telephone | 626-536-6650
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Fax |
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Provider Business Mailing Address
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Address Line | 907 WESTWOOD BLVD # 362
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City | LOS ANGELES
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State | CA
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Zip | 90024-2904
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JEFFREY BRUMBAUGH
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Credential | DDS, MS
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Telephone | 626-536-6650
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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