=====================================================
General NPI Number Information
=====================================================
NPI Number | 1568597250
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | OSAMAH A EL-ATTAR MD INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/22/2007
-----------------------------------------------------
Last Update Date | 02/18/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1234 N VERMONT AVE SUITE 2
-----------------------------------------------------
City | LOS ANGELES
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90029-1704
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 323-666-2726
-----------------------------------------------------
Fax | 323-666-9056
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 800817
-----------------------------------------------------
City | SANTA CLARITA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91380-0817
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 661-430-0935
-----------------------------------------------------
Fax | 866-431-1210
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. OSAMAH AMIN EL-ATTAR
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 323-666-2726
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RC0000X
-----------------------------------------------------
Taxonomy Name | Cardiovascular Disease Physician
-----------------------------------------------------
License Number | A26314
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | A26314
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 207RI0011X
-----------------------------------------------------
Taxonomy Name | Interventional Cardiology Physician
-----------------------------------------------------
License Number | A26314
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------