Provider Demographics
NPI:1467326157
Name:GINELL, BRIAN MICHAEL
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:MICHAEL
Last Name:GINELL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5243 MERIDIAN ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90042-1711
Mailing Address - Country:US
Mailing Address - Phone:805-760-3908
Mailing Address - Fax:
Practice Address - Street 1:5243 MERIDIAN ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90042-1711
Practice Address - Country:US
Practice Address - Phone:805-760-3908
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-03
Last Update Date:2025-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAP44572146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic