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General NPI Number Information
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NPI Number | 1487659116
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Entity Type | Organization
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Legal Business Name | BRUCE TORKAN MD A MEDICAL CORPORATION
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Dates
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Enumeration Date | 06/17/2005
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Last Update Date | 01/20/2011
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Provider Practice Location Address
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Address Line | 820-A SOUTH ALVARADO ST
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City | LOS ANGELES
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State | CA
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Zip | 90057-4010
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Country | US
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Telephone | 213-384-0604
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Fax | 213-384-7125
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Provider Business Mailing Address
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Address Line | PO BOX 57399
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City | LOS ANGELES
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State | CA
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Zip | 90057-0399
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Country | US
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Telephone | 213-384-0604
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Fax | 213-384-7125
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. BRUCE TORKAN
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Credential | M.D.
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Telephone | 213-384-0604
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | A40561
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License Number State | CA
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