Bryan, Washington
Bryan, Washington is an individual health care provider with primary practice located at 11669 Santa Monica Blvd Ste 110 , Los Angeles CA 90025-2929. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pain Medicine, Allopathic & Osteopathic Physicians / Interventional Pain Medicine. Allopathic & Osteopathic Physicians / Interventional Pain Medicine is his primary health care specialty. Bryan, Washington can be contacted via phone (310) 228-3652.Contact Information
Primary practice address
11669 Santa Monica Blvd Ste 110
Los Angeles CA 90025-2929
Phone: (310) 228-3652
Fax: (310) 499-4177
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pain Medicine | 207LP2900X | 61799 | California |
| Allopathic & Osteopathic Physicians / Interventional Pain Medicine | 208VP0014X | 61799 | California |
Profile Details
| NPI number | 1316073455 |
|---|---|
| LBN Legal business name | Bryan, Washington |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 25th, 2007 |
| Last updated | Mar 15th, 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 | 1316073455 | NPPES |
| California | MEDICAID | 00A617991 |
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