Healthcare Provider Details
I. General information
NPI: 1982911160
Provider Name (Legal Business Name): CENTER FOR RHEUMATOLOGY MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/09/2010
Last Update Date: 10/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8640 W 3RD ST SUITE 300
LOS ANGELES CA
90048-3384
US
IV. Provider business mailing address
PO BOX 5762
BEVERLY HILLS CA
90209-5762
US
V. Phone/Fax
- Phone: 310-659-7878
- Fax: 310-659-7117
- Phone: 310-659-7878
- Fax: 310-659-7117
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RR0500X |
| Taxonomy | Rheumatology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ARASH
AARON
HORIZON
Title or Position: CFO
Credential: MD
Phone: 310-659-7878