Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | A119134 | CA |
NPI | 1023133972 |
---|---|
Provider Name | Dr. Michael Benjamin Brewer |
First Address | Downey, CA 90242-2814 |
Second Address | Downey, CA 90242-2814 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2007 |
Last Update Date | 04/11/2021 |