Brent, Dale J

Brent, Dale J is an individual health care provider with primary practice located at 4955 Van Nuys Blvd Ste 400 , Sherman Oaks CA 91403-1812. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Brent, Dale J can be contacted via phone (818) 784-1195.

Contact Information

Primary practice address
4955 Van Nuys Blvd Ste 400 Sherman Oaks CA 91403-1812
Fax: (818) 784-6473
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X A43070 California

Profile Details

NPI number 1992886618
LBN Legal business name Brent, Dale J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 18th, 2006
Last updated Feb 24th, 2020 - about 4 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1992886618 NPPES
California MEDICAID GR0102370

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