MEDICARE: DR. RONALD A MARKMAN M.D.

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	173000000X	Legal Medicine	A19667	CA

General Provider Information

NPI Number	:	1154657286
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RONALD A MARKMAN M.D.

Provider Business Mailing Address
First Line	:	PO BOX 1272
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90213-1272
Country	:	US
Telephone Number	:	310-276-1482
Fax Number	:	310-278-2187

Provider Business Practice Location Address
First Line	:	7891 LA TIJERA BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90045-3145
Country	:	US
Telephone Number	:	310-276-1482
Fax Number	:	310-278-2187

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

Provider Enumeration Date	:	10/23/2009
Last Update Date	:	04/08/2014

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