Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207K00000X | Allergist & Immunologist | G61421 | CA |
Y | 2080P0201X | Pediatric Allergist | G61421 | CA |
NPI | 1821023201 |
---|---|
Provider Name | Brian K Greenberg |
First Address | Laguna Hills, CA 92653-3628 |
Second Address | Tarzana, CA 91356-2804 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2006 |
Last Update Date | 18/01/2022 |