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General NPI Number Information
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NPI Number | 1073548681
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Entity Type | Organization
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Legal Business Name | TOWER PULMONARY ASSOCIATES A MED GROUP
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Dates
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Enumeration Date | 07/12/2006
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Last Update Date | 04/30/2015
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Provider Practice Location Address
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Address Line | 1400 S GRAND AVE STE 605
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City | LOS ANGELES
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State | CA
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Zip | 90015-3068
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Country | US
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Telephone | 213-742-0910
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Fax | 213-742-6631
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Provider Business Mailing Address
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Address Line | 1400 S GRAND AVE STE 605
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City | LOS ANGELES
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State | CA
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Zip | 90015-3068
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Country | US
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Telephone | 213-742-0910
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Fax | 213-742-6631
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROBERT K. ROTHBART
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Credential | MD
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Telephone | 213-742-0910
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A29402
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | G24071
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | G32106
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License Number State | CA
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