MEDICARE: OBAND, INC

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	174400000X	Specialist

General Provider Information

NPI Number	:	1225382054
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OBAND, INC

Provider Business Mailing Address
First Line	:	4333 ADMIRALTY WAY
Second Line	:
City	:	MARINA DEL REY
State	:	CA
Zip	:	90292-5469
Country	:	US
Telephone Number	:	310-821-2549
Fax Number	:

Provider Business Practice Location Address
First Line	:	4333 ADMIRALTY WAY
Second Line	:
City	:	MARINA DEL REY
State	:	CA
Zip	:	90292-5469
Country	:	US
Telephone Number	:	310-821-2549
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ISAAC VERBUKH
Credential	:
Telephone Number	:	310-821-2549

Provider Enumeration Date	:	10/31/2012
Last Update Date	:	10/31/2012

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Directions to “OBAND, INC ” Practice Location

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