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General NPI Number Information
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NPI Number | 1740211978
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Entity Type | Organization
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Legal Business Name | CMC PULMONARY PHYSIOLOGY LABORATORY
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Dates
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Enumeration Date | 07/05/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1401 S GRAND AVE CARDIOPULMONARY DEPARTMENT
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City | LOS ANGELES
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State | CA
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Zip | 90015-3010
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Country | US
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Telephone | 213-742-0910
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Fax | 213-742-6631
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Provider Business Mailing Address
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Address Line | 2300 S FLOWER ST #101
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City | LOS ANGELES
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State | CA
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Zip | 90007-2660
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Country | US
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Telephone | 213-742-0910
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Fax | 213-742-6631
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. ROBERT K. ROTHBART
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Credential | M.D.
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Telephone | 213-742-0910
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 293D00000X
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Taxonomy Name | Physiological Laboratory
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License Number |
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License Number State |
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