Organization · NPI-2

Brian R. Gantwerker, M.D., A Medical Corporation

Neurological Surgery · Santa Monica, CA

NPI number1639475759
StatusActive
Last updated in NPPESJul 19, 2016

Details

NPI
1639475759
Entity type
Organization (NPI-2)
Legal business name
Brian R. Gantwerker, M.D., A Medical Corporation
Organization subpart
No
Enumeration date
Feb 8, 2011
Last updated
Jul 19, 2016

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207T00000X Neurological SurgeryA109316CAYes

Other names

  • The Craniospinal Center Of Los Angeles (Doing Business As)

Practice location

2811 Wilshire Blvd
Suite 840
Santa Monica, CA 90403-4807

Phone 310-694-8300 · Fax 310-694-8357

Mailing address

Po Box 492209
Los Angeles, CA 90049-2209

Phone 310-694-8300 · Fax 310-694-8357

Authorized official

Brian Randall Gantwerker
President
3106948300

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