MEDICARE: DAVID ESTEBAN TOURGEMAN M.D.

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	207VE0102X	Reproductive Endocrinology Physician	A54692	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	A54692	OTHER	CA	MEDICAL LICENSE

General Provider Information

NPI Number	:	1952371973
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID ESTEBAN TOURGEMAN M.D.

Provider Business Mailing Address
First Line	:	333 S ARROYO PKWY
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91105-2515
Country	:	US
Telephone Number	:	626-440-9161
Fax Number	:	626-585-1603

Provider Business Practice Location Address
First Line	:	11500 W OLYMPIC BLVD
Second Line	:	SUITE 504
City	:	LOS ANGELES
State	:	CA
Zip	:	90064-1524
Country	:	US
Telephone Number	:	310-481-0881
Fax Number	:	310-481-9017

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

Provider Enumeration Date	:	01/23/2006
Last Update Date	:	07/08/2007

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