Healthcare Provider Details

I. General information

NPI: 1760566418
Provider Name (Legal Business Name): M M NEUMANN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 10/22/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8631 W 3RD ST #1140 E
LOS ANGELES CA
90048
US

IV. Provider business mailing address

8631 W 3RD ST #1140 E
LOS ANGELES CA
90048
US

V. Phone/Fax

Practice location:
  • Phone: 310-854-3972
  • Fax: 310-652-4053
Mailing address:
  • Phone: 310-854-3972
  • Fax: 310-652-4053

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberA33109
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: