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General NPI Number Information
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NPI Number | 1295366318
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Entity Type | Organization
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Legal Business Name | PHILLIP S BLAND MD INC
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Dates
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Enumeration Date | 01/28/2020
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Last Update Date | 02/28/2020
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Provider Practice Location Address
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Address Line | 1127 WILSHIRE BLVD STE 1010
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City | LOS ANGELES
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State | CA
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Zip | 90017-4001
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Country | US
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Telephone | 213-977-1047
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Fax |
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Provider Business Mailing Address
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Address Line | 1127 WILSHIRE BLVD STE 1010
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City | LOS ANGELES
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State | CA
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Zip | 90017-4001
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Country | US
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Telephone | 213-977-1047
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | PHILLIP S BLAND
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Credential | MD
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Telephone | 213-977-1047
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RS0010X
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Taxonomy Name | Sports Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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