Healthcare Provider Details

I. General information

NPI: 1164477519
Provider Name (Legal Business Name): HOWARD RESIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23560 MADISON ST 211
TORRANCE CA
90505-4708
US

IV. Provider business mailing address

23560 MADISON ST 211
TORRANCE CA
90505-4708
US

V. Phone/Fax

Practice location:
  • Phone: 310-539-2055
  • Fax: 310-530-3999
Mailing address:
  • Phone: 310-539-2055
  • Fax: 310-530-3999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberG19482
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: