MEDICARE: BRUCE TORKAN, M.D. INC., A MEDICAL CORPORATION

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	291U00000X	Clinical Medical Laboratory	A40561	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104901164
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRUCE TORKAN, M.D. INC., A MEDICAL CORPORATION

Provider Business Mailing Address
First Line	:	PO BOX 57399
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90057-0399
Country	:	US
Telephone Number	:	213-384-0604
Fax Number	:	213-384-7125

Provider Business Practice Location Address
First Line	:	820-A SOUTH ALVARADO STREET
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90057-4010
Country	:	US
Telephone Number	:	213-384-0604
Fax Number	:	213-384-7125

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. BRUCE TORKAN
Credential	:	M.D.
Telephone Number	:	310-922-5571

Provider Enumeration Date	:	10/26/2006
Last Update Date	:	07/22/2008

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