James S. Brust, M.d., Inc. | |
2403 S Moray Ave Suite #4 San Pedro CA 90732-4342 | |
(310) 832-7943 | |
(310) 514-8017 |
Full Name | James S. Brust, M.d., Inc. |
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Speciality | Psychiatry & Neurology |
Location | 2403 S Moray Ave, San Pedro, California |
Authorized Official Name and Position | James S. Brust (PRESIDENT) |
Authorized Official Contact | 3108327943 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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James S. Brust, M.d., Inc. 2403 S Moray Ave Suite #4 San Pedro CA 90732-4342 Ph: (310) 832-7943 | James S. Brust, M.d., Inc. 2403 S Moray Ave Suite #4 San Pedro CA 90732-4342 Ph: (310) 832-7943 |
NPI Number | 1881963080 |
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Provider Enumeration Date | 12/19/2011 |
Last Update Date | 12/19/2011 |
Medicare PECOS PAC ID | 4789841073 |
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Medicare Enrollment ID | O20120127000659 |
Identifier | Type | State | Issuer |
---|---|---|---|
1881963080 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
Provider Name | James S Brust |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1427184571 PECOS PAC ID: 5294992582 Enrollment ID: I20120127000708 |
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