MEDICARE: COURTLAN BUDMAN

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	363L00000X	Nurse Practitioner	15309	CA

General Provider Information

NPI Number	:	1972820082
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COURTLAN BUDMAN

Provider Business Mailing Address
First Line	:	8612 HILLSIDE AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90069-1509
Country	:	US
Telephone Number	:	310-924-1729
Fax Number	:

Provider Business Practice Location Address
First Line	:	436 N BEDFORD DR STE 202
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90210-4359
Country	:	US
Telephone Number	:	310-271-1103
Fax Number	:

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

Provider Enumeration Date	:	04/28/2010
Last Update Date	:	04/28/2010

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Directions to “ COURTLAN BUDMAN ” Practice Location

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