Healthcare Provider Details

I. General information

NPI: 1619957750
Provider Name (Legal Business Name): DEREN MARK SINKOWITZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2006
Last Update Date: 05/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3701 SKYPARK DR # 200
TORRANCE CA
90505-4753
US

IV. Provider business mailing address

3701 SKYPARK DR # 200
TORRANCE CA
90505-4753
US

V. Phone/Fax

Practice location:
  • Phone: 310-378-8900
  • Fax: 310-791-0786
Mailing address:
  • Phone: 310-378-8900
  • Fax: 310-791-0786

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number107553
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number107553
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number107553
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: