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General NPI Number Information
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NPI Number | 1588620363
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Entity Type | Individual
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Provider Name | ATUL MADAN MD
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Gender | Male
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Dates
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Enumeration Date | 04/21/2006
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Last Update Date | 04/15/2025
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Provider Practice Location Address
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Address Line | 1310 W STEWART DR STE 310
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City | ORANGE
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State | CA
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Zip | 92868-3838
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Country | US
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Telephone | 562-270-5411
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Fax | 424-248-0985
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Provider Business Mailing Address
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Address Line | 10573 W PICO BLVD # 859
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City | LOS ANGELES
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State | CA
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Zip | 90064-2333
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Country | US
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Telephone | 310-869-7776
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Fax | 866-933-0664
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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 | 2083B0002X
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Taxonomy Name | Obesity Medicine (Preventive Medicine) Physician
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License Number | C53803
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2086P0122X
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Taxonomy Name | Physician Nutrition Specialist (Surgery)
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License Number | C53803
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | C53803
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License Number State | CA
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