Brackmann, Derald E
Brackmann, Derald E is an individual health care provider with primary practice located at 2100 W 3Rd St Ste 111 , Los Angeles CA 90057-1999. He recently has only one registered license in Allopathic & Osteopathic Physicians / Otology & Neurotology, which is considered as his primary health care specialty. Brackmann, Derald E can be contacted via phone (213) 483-9930.Contact Information
Primary practice address
2100 W 3Rd St Ste 111
Los Angeles CA 90057-1999
Phone: (213) 483-9930
Fax: (213) 483-0905
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Otology & Neurotology | 207YX0901X | G11124 | California |
Profile Details
| NPI number | 1508876699 |
|---|---|
| LBN Legal business name | Brackmann, Derald E |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 9th, 2006 |
| Last updated | Sep 3rd, 2013 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1508876699 | NPPES |
| California | MEDICAID | 00G111240 |
Popular Providers
-
Mckennan, Kevin X
1111 Exposition Blvd Bldg 700 , Sacramento CA 95815-4314 -
Lippy, William Henry
3893 E Market St , Warren OH 44484-4706 -
Voelker, Courtney C. J.
11645 Wilshire Blvd Ste 600 , Los Angeles CA 90025-6807 -
Vorasubin, Nopawan
4867 W Sunset Blvd , Los Angeles CA 90027-5969 -
Ostrowski, Vincent Benedict
7440 N Shadeland Ave Ste 150, Indianapolis IN 46250-2095 -
Berenholz, Leonard P
3893 E Market St , Warren OH 44484-4706 -
House, John W
2100 W 3Rd St Suite 111, Los Angeles CA 90057-1944 -
Meenan, Kirsten Danielle
200 Ucla Medical Plz Ste 550 , Los Angeles CA 90095-1606