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General NPI Number Information
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NPI Number | 1285034843
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Entity Type | Organization
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Legal Business Name | REFUAH RECOVERY MEDICAL GROUP
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Dates
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Enumeration Date | 09/01/2014
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Last Update Date | 09/01/2014
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Provider Practice Location Address
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Address Line | 947 S RIDGELEY DR
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City | LOS ANGELES
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State | CA
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Zip | 90036-4705
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Country | US
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Telephone | 323-965-1365
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Fax | 785-955-6014
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Provider Business Mailing Address
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Address Line | 5675 W OLYMPIC BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90036-4712
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Country | US
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Telephone | 323-965-1365
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Fax | 786-955-6015
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. BINYAMIN AMRAMI
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Credential | M.D
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Telephone | 323-965-1365
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | A116722
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License Number State | CA
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