Healthcare Provider Details

I. General information

NPI: 1891721098
Provider Name (Legal Business Name): DAVID ENGMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2006
Last Update Date: 01/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8700 BEVERLY BLVD SUITE 8707
WEST HOLLYWOOD CA
90048-1804
US

IV. Provider business mailing address

8700 BEVERLY BLVD SUITE 8707
WEST HOLLYWOOD CA
90048-1804
US

V. Phone/Fax

Practice location:
  • Phone: 310-423-6627
  • Fax: 310-423-0170
Mailing address:
  • Phone: 310-423-6627
  • Fax: 310-423-0170

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0105X
TaxonomyClinical Pathology/Laboratory Medicine Physician
License Number036087137
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: