Healthcare Provider Details
I. General information
NPI: 1134416068
Provider Name (Legal Business Name): BUMA MEDICAL INC A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/29/2011
Last Update Date: 03/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9001 WILSHIRE BLVD STE 106
BEVERLY HILLS CA
90211-1839
US
IV. Provider business mailing address
8581 SANTA MONICA BLVD # 975
WEST HOLLYWOOD CA
90069-4120
US
V. Phone/Fax
- Phone: 310-230-5741
- Fax:
- Phone: 310-230-5741
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208200000X |
| Taxonomy | Plastic Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ELLIOT
ALPERT
Title or Position: ATTORNEY
Credential:
Phone: 310-230-5741