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NPI Code Detail

MEDICARE: ROBERT L LEIBOWITZ MD A PROFESSIONAL MEDICAL CORPORATION

MEDICARE: ROBERT L LEIBOWITZ MD A PROFESSIONAL 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
1207RX0202XMedical Oncology PhysicianG28905CA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1WPA15424BOTHERCAMEDICARE PTAN FOR NPP

General Provider Information

NPI Number : 1285644963
Entity Type Code : Organization
Provider Name (Legal Business Name) : ROBERT L LEIBOWITZ MD A PROFESSIONAL MEDICAL CORPORATION
Provider Business Mailing Address
First Line : 2080 CENTURY PARK E
Second Line : SUITE 1005
City : LOS ANGELES
State : CA
Zip : 90067-2013
Country : US
Telephone Number : 310-229-3555
Fax Number : 310-229-3554
Provider Business Practice Location Address
First Line : 2080 CENTURY PARK E
Second Line : SUITE 1005
City : LOS ANGELES
State : CA
Zip : 90067-2013
Country : US
Telephone Number : 310-229-3555
Fax Number : 310-229-3554
Authorized Official
Title or Position : PRESIDENT
Name : DR. ROBERT L LEIBOWITZ
Credential : M.D.
Telephone Number : 310-229-3555
Provider Enumeration Date : 08/08/2006
Last Update Date : 05/24/2016

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