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General NPI Number Information
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NPI Number | 1689957805
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Entity Type | Organization
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Legal Business Name | MEDBIL, LLC
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Dates
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Enumeration Date | 09/23/2011
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Last Update Date | 09/23/2011
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Provider Practice Location Address
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Address Line | 1024 OXFORD AVE.
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City | MARINA DEL REY
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State | CA
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Zip | 90292
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Country | US
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Telephone | 310-306-5502
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Fax |
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Provider Business Mailing Address
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Address Line | P.O. BOX 12973
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City | MARINA DEL REY
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State | CA
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Zip | 90295
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Country | US
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Telephone | 310-306-5502
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ALEXANDER SOROKURS
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Credential | M.D.
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Telephone | 310-622-5369
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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