| Brent Jacob Geffen, MD | |
|
2876 Sycamore Dr, Simi Valley, CA 93065-1530 | |
| (805) 379-9646 | |
| Not Available |
| Full Name | Brent Jacob Geffen |
|---|---|
| Gender | Male |
| Speciality | Otolaryngology |
| Location | 2876 Sycamore Dr, Simi Valley, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528562527 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Y00000X | Otolaryngology | 185833 (California) | Primary |
| 207Y00000X | Otolaryngology | 11393298-1205 (Utah) | Secondary |
| Entity Name | West Coast Ear, Nose And Throat |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1588868863 PECOS PAC ID: 9638352503 Enrollment ID: O20110330000774 |
| Mailing Address | Practice Location Address |
|---|---|
| Brent Jacob Geffen, MD 2876 Sycamore Dr, Simi Valley, CA 93065-1530 Ph: (805) 379-9646 | Brent Jacob Geffen, MD 2876 Sycamore Dr, Simi Valley, CA 93065-1530 Ph: (805) 379-9646 |
Dr. Mark David Kayne, M.D. Otolaryngology Medicare: Not Enrolled in Medicare Practice Location: 953 Clear Sky Pl, Simi Valley, CA 93065 Phone: 805-526-3621 Fax: 805-526-3621 | |
Dr. Martin Edward Wareham, M.D. Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 2876 Sycamore Dr, Ste 303, Simi Valley, CA 93065 Phone: 805-379-9646 Fax: 805-379-0611 |