Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YP0228X | Pediatric Otolaryngology | G67825 | CA |
NPI | 1609848316 |
---|---|
Provider Name | Dr. Douglas Frank Brewster |
First Address | San Diego, CA 92121-6310 |
Second Address | San Diego, CA 92121-6310 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2006 |
Last Update Date | 14/06/2013 |