Healthcare Provider Details
I. General information
NPI: 1609993146
Provider Name (Legal Business Name): IRWIN SAVODNIK, M.D. & MEDICAL ASSOCIATES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/22/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2266 UNION ST
SAN FRANCISCO CA
94123-3940
US
IV. Provider business mailing address
2780 SKYPARK DR STE 260
TORRANCE CA
90505-5342
US
V. Phone/Fax
- Phone: 310-517-1717
- Fax: 310-517-9853
- Phone: 310-517-1717
- Fax: 310-517-9853
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103G00000X |
| Taxonomy | Clinical Neuropsychologist |
| License Number | A66459 |
| License Number State | CA |
VIII. Authorized Official
Name: DR.
LAURA
DAVIES
Title or Position: PSYCHIATRY
Credential: M.D.
Phone: 310-517-1717