NPI 1003933979

Brent Blair, MA

Practitioner Contractor Los Angeles, CA

Practice location

Address: 1200 Wilshire Blvd STE 500, Los Angeles, CA 90017-1934
Phone: (213) 481-7464
Mailing address: 643 Grant St APT F, Santa Monica, CA 90405-1248

Registered specialties

Contractor Primary

Other Service Providers Taxonomy 171W00000X

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Registry record

NPI: 1003933979
Entity type: Individual
Sex (as registered): Male
NPI issued: 23 Mar 2007
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.