MEDICARE: DR. BARBARA CAMILLE BREGER M.D.

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	207W00000X	Ophthalmology Physician	21666	ND
2	207W00000X	Ophthalmology Physician	A21132	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	A21132	OTHER	CA	INSURERS AS BC, BS, ETC

General Provider Information

NPI Number	:	1588664817
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BARBARA CAMILLE BREGER M.D.

Provider Business Mailing Address
First Line	:	9905 STELLBAR PL
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90064-4645
Country	:	US
Telephone Number	:	310-274-8725
Fax Number	:	310-276-0163

Provider Business Practice Location Address
First Line	:	9905 STELLBAR PL
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90064-4645
Country	:	US
Telephone Number	:	310-274-8725
Fax Number	:	310-276-0163

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

Provider Enumeration Date	:	07/28/2005
Last Update Date	:	11/11/2024

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