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General NPI Number Information
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NPI Number | 1013306364
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Entity Type | Organization
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Legal Business Name | MARC LADENHEIM MD FACC INC
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Dates
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Enumeration Date | 01/09/2015
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Last Update Date | 11/02/2016
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Provider Practice Location Address
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Address Line | 2701 W ALAMEDA AVE SUITE 607
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City | BURBANK
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State | CA
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Zip | 91505-4402
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Country | US
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Telephone | 818-846-3201
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Fax | 818-846-3939
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Provider Business Mailing Address
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Address Line | 2701 W ALAMEDA AVE SUITE 607
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City | BURBANK
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State | CA
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Zip | 91505-4402
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Country | US
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Telephone | 818-846-3201
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Fax | 818-846-3939
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Authorized Official
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Title or Position | OFFICER
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Name | MARC L LADENHEIM
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Credential | M.D.
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Telephone | 818-846-3201
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | G049875
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License Number State | CA
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