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General NPI Number Information
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NPI Number | 1770710501
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Entity Type | Individual
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Provider Name | BRIAN HURLEY MD, MBA
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Gender | Male
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Dates
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Enumeration Date | 06/19/2009
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Last Update Date | 10/01/2015
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Provider Practice Location Address
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Address Line | 10780 SANTA MONICA BLVD STE 105
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City | LOS ANGELES
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State | CA
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Zip | 90025-7613
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Country | US
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Telephone | 310-903-9653
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Fax | 310-382-2089
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Provider Business Mailing Address
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Address Line | 10940 WILSHIRE BLVD STE 710 C/O CHRISTINA PUNZALAN
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City | LOS ANGELES
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State | CA
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Zip | 90095-7394
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Country | US
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Telephone | 323-457-3675
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Fax | 310-382-2089
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0802X
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Taxonomy Name | Addiction Psychiatry Physician
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License Number | 130543
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2084A0401X
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Taxonomy Name | Addiction Medicine (Psychiatry & Neurology) Physician
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License Number | 130543
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 130543
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License Number State | CA
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