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General NPI Number Information
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NPI Number | 1447218045
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Entity Type | Individual
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Provider Name | BARTON TANENBAUM MD
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Gender | Male
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Dates
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Enumeration Date | 05/03/2006
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Last Update Date | 06/12/2019
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Provider Practice Location Address
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Address Line | 201 S ALVARADO ST SUITE 215
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City | LOS ANGELES
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State | CA
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Zip | 90057-2320
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Country | US
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Telephone | 213-484-9900
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Fax | 213-484-0158
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Provider Business Mailing Address
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Address Line | 1127 WILSHIRE BLVD STE 805
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City | LOS ANGELES
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State | CA
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Zip | 90017-3909
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Country | US
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Telephone | 213-484-9900
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Fax | 213-484-0158
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | G19250
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License Number State | CA
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