MEDICARE: JOEL FREDERICK FINE, MD A MED

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	207L00000X	Anesthesiology Physician	A42331	CA

General Provider Information

NPI Number	:	1881898740
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOEL FREDERICK FINE, MD A MED

Provider Business Mailing Address
First Line	:	PO BOX 3098
Second Line	:
City	:	TORRANCE
State	:	CA
Zip	:	90510-3098
Country	:	US
Telephone Number	:	310-792-3914
Fax Number	:	310-792-3621

Provider Business Practice Location Address
First Line	:	6245 DE LONGPRE AVE
Second Line	:
City	:	HOLLYWOOD
State	:	CA
Zip	:	90028-8253
Country	:	US
Telephone Number	:	323-462-2271
Fax Number	:

Authorized Official
Title or Position	:	INCORPORATOR
Name	:	DR. JOEL F FINE
Credential	:	M.D.
Telephone Number	:	310-792-3914

Provider Enumeration Date	:	06/13/2007
Last Update Date	:	04/18/2008

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