Brent Blair, MA
Individual provider Active NPI Contractor · Los Angeles, CA
NPI 1003933979 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1003933979
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Contractor 171W00000X
- Practice address
- 1200 Wilshire Blvd Ste 500
Los Angeles, CA 90017-1934 - Phone
- (213) 481-7464
- NPI assigned
- Mar 23, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Arts
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Amanecer Community Counseling Service, a Non-Profit Corporation | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | Yes |
Addresses
Primary practice location
1200 Wilshire Blvd Ste 500
Los Angeles, CA 90017-1934
Mailing address
643 Grant St Apt F
Santa Monica, CA 90405-1248
Phone (323) 356-2552
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.