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General NPI Number Information
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NPI Number | 1043870348
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Entity Type | Organization
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Legal Business Name | OSBORNE HEAD AND NECK SPECIALTY GROUP
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Dates
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Enumeration Date | 06/18/2019
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Last Update Date | 06/18/2019
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Provider Practice Location Address
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Address Line | 8631 W 3RD ST STE 945E
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City | LOS ANGELES
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State | CA
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Zip | 90048-5912
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Country | US
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Telephone | 310-657-0123
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Fax |
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Provider Business Mailing Address
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Address Line | 8631 W 3RD ST STE 945E
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City | LOS ANGELES
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State | CA
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Zip | 90048-5912
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Country | US
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Telephone | 310-657-0123
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Fax |
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | DR. RYAN FREDRICK OSBORNE
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Credential | MD
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Telephone | 310-657-0123
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number |
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License Number State |
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