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General NPI Number Information
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NPI Number | 1679840169
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Entity Type | Organization
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Legal Business Name | BROTMAN MEDICAL CENTER, INC.
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Dates
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Enumeration Date | 11/28/2011
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Last Update Date | 11/28/2011
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Provider Practice Location Address
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Address Line | 3828 DELMAS TER
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City | CULVER CITY
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State | CA
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Zip | 90232-2713
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Country | US
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Telephone | 310-836-7000
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Fax | 310-202-4186
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Provider Business Mailing Address
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Address Line | 3828 DELMAS TER
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City | CULVER CITY
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State | CA
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Zip | 90232-2713
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Country | US
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Telephone | 310-836-7000
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Fax | 310-202-4186
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Authorized Official
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Title or Position | CORPORATE COUNSEL
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Name | MR. GARRISON GRAWOIG DELEE
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Credential | JD
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Telephone | 310-836-7000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 276400000X
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Taxonomy Name | Substance Use Disorder Rehabilitation Hospital Unit
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License Number | 930000022
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License Number State | CA
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