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General NPI Number Information
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NPI Number | 1912252644
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Entity Type | Organization
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Legal Business Name | BRENTWOOD CENTER FOR ADVANCED MEDICINE, PC
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Dates
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Enumeration Date | 07/18/2012
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Last Update Date | 07/18/2012
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Provider Practice Location Address
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Address Line | 11677 SAN VICENTE BLVD SUITE 208
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City | LOS ANGELES
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State | CA
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Zip | 90049-5123
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Country | US
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Telephone | 310-400-5664
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Fax | 310-400-5601
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Provider Business Mailing Address
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Address Line | 11677 SAN VICENTE BLVD SUITE 208
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City | LOS ANGELES
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State | CA
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Zip | 90049-5123
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Country | US
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Telephone | 310-400-5664
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Fax | 310-400-5601
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. ROBIN BERNHOFT
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Credential | M.D.
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Telephone | 310-400-5664
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175F00000X
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Taxonomy Name | Naturopath
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License Number | CA-510
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License Number State | CA
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