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General NPI Number Information
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NPI Number | 1225337579
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Entity Type | Organization
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Legal Business Name | DAVID GHOZLAND, MD, INC
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Dates
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Enumeration Date | 03/24/2011
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Last Update Date | 03/24/2011
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Provider Practice Location Address
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Address Line | 530 WILSHIRE BLVD STE 202B
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City | SANTA MONICA
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State | CA
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Zip | 90401-1427
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Country | US
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Telephone | 310-393-9359
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Fax | 310-451-7807
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Provider Business Mailing Address
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Address Line | 530 WILSHIRE BLVD STE 202B
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City | SANTA MONICA
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State | CA
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Zip | 90401-1427
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Country | US
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Telephone | 310-393-9359
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Fax | 310-451-7807
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Authorized Official
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Title or Position | CEO
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Name | DR. DAVID GHOZLAND
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Credential | M.D.
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Telephone | 310-393-9359
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | A86726
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License Number State | CA
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