MEDICARE: ROBERT MICHAEL HIRSCHHORN LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	MFT34308	CA

General Provider Information

NPI Number	:	1013075084
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT MICHAEL HIRSCHHORN LMFT

Provider Business Mailing Address
First Line	:	6124 BUCKINGHAM PKWY UNIT 304
Second Line	:
City	:	CULVER CITY
State	:	CA
Zip	:	90230-7224
Country	:	US
Telephone Number	:	323-290-8705
Fax Number	:

Provider Business Practice Location Address
First Line	:	6124 BUCKINGHAM PKWY UNIT 304
Second Line	:
City	:	CULVER CITY
State	:	CA
Zip	:	90230-7224
Country	:	US
Telephone Number	:	323-290-8705
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/04/2006
Last Update Date	:	07/08/2007

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