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General NPI Number Information
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NPI Number | 1730561978
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Entity Type | Organization
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Legal Business Name | NOBLE PHYSICIANS MEDICAL GROUP CORP INC
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Dates
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Enumeration Date | 06/24/2015
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Last Update Date | 01/09/2025
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Provider Practice Location Address
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Address Line | 8737 BEVERLY BLVD STE 301
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City | WEST HOLLYWOOD
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State | CA
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Zip | 90048-1839
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Country | US
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Telephone | 323-765-1500
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Fax | 310-363-7046
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Provider Business Mailing Address
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Address Line | PO BOX 251247
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City | LOS ANGELES
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State | CA
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Zip | 90025-9747
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Country | US
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Telephone | 323-938-9999
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Fax | 323-456-0880
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Authorized Official
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Title or Position | PRESIDENT
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Name | DAVID BENJAMIN LALEZARI
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Credential | MD
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Telephone | 818-430-4000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A117709
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License Number State | CA
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