Brim, Mark A.

Brim, Mark A. is an sole proprietor health care provider with primary practice located at 17200 Ventura Blvd Ste 207 Suite 110, Encino CA 91316-4096. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Brim, Mark A. can be contacted via phone (818) 783-3338.

Contact Information

Primary practice address
17200 Ventura Blvd Ste 207 Suite 110 Encino CA 91316-4096
Phone: (818) 783-3338
Fax: (818) 583-1444
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X E1542 California

Profile Details

NPI number 1396776092
LBN Legal business name Brim, Mark A.
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 5th, 2006
Last updated Sep 10th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396776092 NPPES
California MEDICAID 00E15420

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