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General NPI Number Information
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NPI Number | 1467649723
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Entity Type | Organization
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Legal Business Name | JUDITH REICHMAN MD A MEDICAL CORP
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Dates
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Enumeration Date | 10/01/2007
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Last Update Date | 10/12/2012
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Provider Practice Location Address
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Address Line | 2080 CENTURY PARK E 1009
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City | LOS ANGELES
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State | CA
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Zip | 90067-2001
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Country | US
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Telephone | 310-659-9690
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Fax | 310-277-9690
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Provider Business Mailing Address
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Address Line | 2080 CENTURY PARK EAST 1009
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City | LOS ANGELES
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State | CA
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Zip | 90067
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Country | US
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Telephone | 310-659-9690
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Fax | 310-277-9690
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Authorized Official
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Title or Position | OWNER
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Name | JUDITH REICHMAN
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Credential | M.D.
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Telephone | 310-659-9690
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | A35620
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License Number State | CA
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