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General NPI Number Information
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NPI Number | 1689862732
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Entity Type | Organization
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Legal Business Name | ISRAEL GORINSTEIN M.D., INC
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Dates
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Enumeration Date | 10/12/2007
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Last Update Date | 08/14/2014
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Provider Practice Location Address
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Address Line | 5901 W OLYMPIC BLVD SUITE 203
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City | LOS ANGELES
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State | CA
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Zip | 90036-4667
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Country | US
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Telephone | 323-931-1100
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Fax | 323-930-1354
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Provider Business Mailing Address
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Address Line | PO BOX 480560
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City | LOS ANGELES
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State | CA
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Zip | 90048-1560
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Country | US
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Telephone | 323-931-1100
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Fax | 323-930-1354
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Authorized Official
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Title or Position | MANAGER
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Name | RACHEL / LAURA GORINSTEIN
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Credential |
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Telephone | 323-931-1100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | A35991
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License Number State | CA
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