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General NPI Number Information
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NPI Number | 1851730212
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Entity Type | Organization
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Legal Business Name | CORY A WALDMAN M D A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 06/19/2013
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Last Update Date | 06/03/2022
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Provider Practice Location Address
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Address Line | 435 N ROXBURY DR SUITE 300
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City | BEVERLY HILLS
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State | CA
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Zip | 90210-5027
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Country | US
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Telephone | 424-239-1499
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Fax |
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Provider Business Mailing Address
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Address Line | 435 N ROXBURY DR SUITE 300
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City | BEVERLY HILLS
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State | CA
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Zip | 90210-5027
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Country | US
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Telephone | 424-239-1499
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Fax |
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Authorized Official
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Title or Position | MD
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Name | CORY ADAM WALDMAN
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Credential | MD
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Telephone | 424-239-1499
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease 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 | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number | A1235635
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License Number State | CA
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