Provider Demographics
NPI:1861688061
Name:AMARPREET S BRAR MD INC.
Entity type:Organization
Organization Name:AMARPREET S BRAR MD INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMARPREET
Authorized Official - Middle Name:
Authorized Official - Last Name:BRAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-219-7701
Mailing Address - Street 1:1045 W REDONDO BEACH BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:GARDENA
Mailing Address - State:CA
Mailing Address - Zip Code:90247-4180
Mailing Address - Country:US
Mailing Address - Phone:310-219-7701
Mailing Address - Fax:
Practice Address - Street 1:1045 W REDONDO BEACH BLVD STE 400
Practice Address - Street 2:
Practice Address - City:GARDENA
Practice Address - State:CA
Practice Address - Zip Code:90247-4180
Practice Address - Country:US
Practice Address - Phone:310-219-7701
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-20
Last Update Date:2018-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA77993207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5254840001Medicare NSC
CAW17946Medicare PIN