MEDICARE: ARNOLD J BRENDER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician	G49205	CA

General Provider Information

NPI Number	:	1396732053
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARNOLD J BRENDER MD

Provider Business Mailing Address
First Line	:	17742 BEACH BLVD
Second Line	:	STE 215
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92647-6818
Country	:	US
Telephone Number	:	714-848-1655
Fax Number	:	714-847-4348

Provider Business Practice Location Address
First Line	:	17742 BEACH BLVD
Second Line	:	STE 215
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92647-6818
Country	:	US
Telephone Number	:	714-848-1655
Fax Number	:	714-847-4348

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/28/2005
Last Update Date	:	01/05/2010

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