Provider Demographics
NPI:1770710501
Name:HURLEY, BRIAN (MD, MBA)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:HURLEY
Suffix:
Gender:M
Credentials:MD, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10940 WILSHIRE BLVD STE 710
Mailing Address - Street 2:C/O CHRISTINA PUNZALAN
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90095-7394
Mailing Address - Country:US
Mailing Address - Phone:323-457-3675
Mailing Address - Fax:310-382-2089
Practice Address - Street 1:10780 SANTA MONICA BLVD STE 105
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-7613
Practice Address - Country:US
Practice Address - Phone:310-903-9653
Practice Address - Fax:310-382-2089
Is Sole Proprietor?:No
Enumeration Date:2009-06-19
Last Update Date:2015-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1305432084P0802X, 2084A0401X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry
No2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Medicine