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General NPI Number Information
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NPI Number | 1093223034
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Entity Type | Organization
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Legal Business Name | ANATOL PODOLSKY MD INC
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Dates
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Enumeration Date | 01/11/2018
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Last Update Date | 07/06/2020
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Provider Practice Location Address
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Address Line | 18035 BROOKHURST ST STE 1200
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-6738
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Country | US
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Telephone | 949-644-6882
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Fax | 949-644-2377
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Provider Business Mailing Address
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Address Line | 400 NEWPORT CENTER DR STE 601
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-7685
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Country | US
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Telephone | 949-644-6882
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Fax | 949-644-2377
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Authorized Official
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Title or Position | CEO / OWNER
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Name | ANATOL PODOLSKY
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Credential | MD
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Telephone | 949-644-6882
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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