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General NPI Number Information
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NPI Number | 1912272402
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Entity Type | Organization
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Legal Business Name | SCHENDEL MD BROUJERDI MD INC
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Dates
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Enumeration Date | 03/15/2012
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Last Update Date | 03/15/2012
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Provider Practice Location Address
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Address Line | 881 ALMA REAL DR SUITE 204
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City | PACIFIC PALISADES
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State | CA
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Zip | 90272-3731
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Country | US
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Telephone | 310-857-2088
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Fax |
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Provider Business Mailing Address
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Address Line | 881 ALMA REAL DR SUITE 204
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City | PACIFIC PALISADES
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State | CA
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Zip | 90272-3731
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Country | US
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Telephone | 310-857-2088
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. JOSEPH ATA BROUJERDI
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Credential | MD, DMD
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Telephone | 310-857-2088
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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