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General NPI Number Information
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NPI Number | 1437532553
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Entity Type | Organization
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Legal Business Name | PAYMAN R EMMANUEL MD INC
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Dates
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Enumeration Date | 07/07/2015
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Last Update Date | 07/07/2015
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Provider Practice Location Address
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Address Line | 10750 WASHINGTON BLVD
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City | CULVER CITY
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State | CA
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Zip | 90232-3314
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Country | US
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Telephone | 310-253-9999
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Fax | 310-253-9959
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Provider Business Mailing Address
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Address Line | 10750 WASHINGTON BLVD
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City | CULVER CITY
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State | CA
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Zip | 90232-3314
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Country | US
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Telephone | 310-253-9999
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Fax | 310-253-9959
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Authorized Official
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Title or Position | DOCTOR
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Name | PAYMAN RICHARD EMMANUEL
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Credential | MD
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Telephone | 310-413-1006
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number | G085245
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License Number State | CA
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