Provider Demographics
NPI:1578787016
Name:OGAWA, BRENT (MD)
Entity Type:Individual
Prefix:DR
First Name:BRENT
Middle Name:
Last Name:OGAWA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:8231 DELGANY AVE
Mailing Address - Street 2:
Mailing Address - City:PLAYA DEL REY
Mailing Address - State:CA
Mailing Address - Zip Code:90293-7817
Mailing Address - Country:US
Mailing Address - Phone:323-226-7210
Mailing Address - Fax:
Practice Address - Street 1:1200 N STATE ST STE 3900
Practice Address - Street 2:ORTHOPAEDIC DEPT
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90089-1004
Practice Address - Country:US
Practice Address - Phone:323-226-7210
Practice Address - Fax:323-226-4051
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA91222207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery