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General NPI Number Information
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NPI Number | 1851785851
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Entity Type | Organization
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Legal Business Name | PHYZMED ASSOCIATES INC
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Dates
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Enumeration Date | 03/27/2015
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Last Update Date | 12/12/2018
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Provider Practice Location Address
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Address Line | 2801 WILSHIRE BLVD STE A
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City | SANTA MONICA
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State | CA
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Zip | 90403-4801
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Country | US
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Telephone | 855-257-4239
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Fax |
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Provider Business Mailing Address
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Address Line | 1112 MONTANA AVE # 900
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City | SANTA MONICA
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State | CA
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Zip | 90403-1652
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TIMOTHY DAVIS
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Credential | MD
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Telephone | 855-257-4239
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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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