Active NPI
Brian Keith Estwick, MD
- Ophthalmology Physician
- Marina del Rey, CA
National Provider Identifier
1003889247
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- A41775
- Practice address
- 4644 Lincoln Blvd
Ste #430
Marina del Rey, CA 90292-6313 - Phone
- (310) 390-2420
- Fax
- (310) 390-2364
- NPI assigned
- Feb 8, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | A41775 | CA | Primary |
Addresses
Primary practice location
4644 Lincoln Blvd
Ste #430
Marina del Rey, CA 90292-6313
Mailing address
4644 Lincoln Blvd
Ste #430
Marina del Rey, CA 90292-6313
Phone (310) 390-2420
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040203001123 | CA | Practitioner - Ophthalmology | 1153214283 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A41775 | CA | MD | Ophthalmology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139356800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1003889247",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4644 LINCOLN BLVD",
"address_2": "STE #430",
"city": "MARINA DEL REY",
"state": "CA",
"postal_code": "902926313",
"telephone_number": "310-390-2420",
"fax_number": "310-390-2364"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4644 LINCOLN BLVD",
"address_2": "STE #430",
"city": "MARINA DEL REY",
"state": "CA",
"postal_code": "902926313",
"telephone_number": "310-390-2420",
"fax_number": "310-390-2364"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ESTWICK",
"first_name": "BRIAN",
"middle_name": "KEITH",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-08",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "CA",
"license": "A41775",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marina del Rey, CA
- Elizabeth Gould, Marriage & Family Therapist, Inc.
- Xavier Elizarraraz
- Eric J. Klostermann, D.P.M., a Professional Corporation
- Esse Care Surgery California PC
- Carmely Estrella, PH.D., LCSW
- Etie Moghissi, MD,Inc
- Izunna Vincent Ewudo, DNP, FNP-C, PMHNP-BC
- Expanse Wellness Acupuncture and Physical Therapy
- Eyes of the Marina Optometry
- Alejandro Christian Fajardo II
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.