Healthcare Provider Details

I. General information

NPI: 1568686855
Provider Name (Legal Business Name): IRWIN SAVODNIK, M.D. & MEDICAL ASSOCIATES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555TACHEVAH DR. BLDG. 1 W #105
PALM SPRINGS CA
92262
US

IV. Provider business mailing address

2780 SKYPARK DR STE 260
TORRANCE CA
90505-5342
US

V. Phone/Fax

Practice location:
  • Phone: 310-517-1717
  • Fax: 310-517-9853
Mailing address:
  • Phone: 310-517-1717
  • Fax: 310-517-9853

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY 14596
License Number StateCA

VIII. Authorized Official

Name: DR. KATHLEEN MOORE
Title or Position: PSYCHOLOGIST
Credential: PSY. D.
Phone: 310-517-1717