MEDICARE: MR. DAVID JOSEPHSON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208800000X	Urology Physician	A75701	CA

General Provider Information

NPI Number	:	1063510840
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DAVID JOSEPHSON MD

Provider Business Mailing Address
First Line	:	8635 W 3RD ST STE 1
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90048-6102
Country	:	US
Telephone Number	:	310-854-9898
Fax Number	:	310-854-0627

Provider Business Practice Location Address
First Line	:	8635 W 3RD ST STE 1
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90048-6102
Country	:	US
Telephone Number	:	310-854-9898
Fax Number	:	310-854-0627

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	06/10/2011

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