Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | CFE25219 | CA |
NPI | 1154636769 |
---|---|
Provider Name | Dr. Louis G. Brennan |
First Address | Laguna Niguel, CA 92677 |
Second Address | Laguna Niguel, CA 92677-9380 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2010 |
Last Update Date | 09/08/2010 |