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General NPI Number Information
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NPI Number | 1992728109
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Entity Type | Individual
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Provider Name | BRIGITTE NOLA GOMPERTS M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 01/17/2013
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Provider Practice Location Address
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Address Line | 10833 LE CONTE AVE 12-441 MDCC
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City | LOS ANGELES
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State | CA
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Zip | 90095-3075
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Country | US
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Telephone | 310-206-3952
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Fax | 310-206-0209
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Provider Business Mailing Address
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Address Line | 10833 LE CONTE AVE 12-441 MDCC
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City | LOS ANGELES
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State | CA
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Zip | 90095-3075
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Country | US
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Telephone | 310-825-6708
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Fax | 310-206-8089
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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 | 2080P0207X
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Taxonomy Name | Pediatric Hematology & Oncology Physician
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License Number | A84496
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License Number State | CA
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