Healthcare Provider Details

I. General information

NPI: 1710796206
Provider Name (Legal Business Name): EMBO PARTNERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/30/2024
Last Update Date: 12/30/2024
Certification Date: 12/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8436 W 3RD ST STE 800
LOS ANGELES CA
90048-4100
US

IV. Provider business mailing address

1611 N DOHENY DR
LOS ANGELES CA
90069-1105
US

V. Phone/Fax

Practice location:
  • Phone: 424-800-3627
  • Fax:
Mailing address:
  • Phone: 310-876-9325
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. H GABRIEL LIPSHUTZ
Title or Position: CEO
Credential: MD
Phone: 310-876-9325