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General NPI Number Information
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NPI Number | 1891652129
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Entity Type | Organization
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Legal Business Name | AEVUM PERFORMANCE & UROLOGY
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Dates
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Enumeration Date | 01/08/2026
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Last Update Date | 01/08/2026
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Provider Practice Location Address
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Address Line | 11600 WILSHIRE BLVD STE 600
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City | LOS ANGELES
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State | CA
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Zip | 90025-5781
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Country | US
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Telephone | 818-876-5649
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Fax |
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Provider Business Mailing Address
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Address Line | 11600 WILSHIRE BLVD STE 600
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City | LOS ANGELES
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State | CA
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Zip | 90025-5781
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Country | US
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Telephone | 818-876-5649
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Fax |
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Authorized Official
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Title or Position | CEO/LEAD PHYSICIAN
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Name | DR. AUDLEY OSBOURNE
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Credential | MD
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Telephone | 347-564-7818
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number |
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License Number State |
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