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General NPI Number Information
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NPI Number | 1841380094
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Entity Type | Individual
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Provider Name | DAVID MORDECAI M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/16/2006
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Last Update Date | 12/02/2024
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Provider Practice Location Address
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Address Line | 6341 W 5TH ST
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City | LOS ANGELES
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State | CA
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Zip | 90048-4717
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Country | US
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Telephone | 877-563-4820
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Fax | 310-695-2787
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Provider Business Mailing Address
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Address Line | PO BOX 90818
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City | LOS ANGELES
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State | CA
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Zip | 90009-0818
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Country | US
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Telephone | 877-563-4820
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Fax | 310-695-2787
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | G47306
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | G47306
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License Number State | CA
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