MEDICARE: PAVEL BRAUNSHTEIN

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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1285680785
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PAVEL BRAUNSHTEIN

Provider Business Mailing Address
First Line	:	6428 1/2 COLDWATER CANYON AVE
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91606-1113
Country	:	US
Telephone Number	:	818-590-0433
Fax Number	:	818-761-5968

Provider Business Practice Location Address
First Line	:	6428 1/2 COLDWATER CANYON AVE
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91606-1113
Country	:	US
Telephone Number	:	818-590-0433
Fax Number	:	818-761-5968

Authorized Official
Title or Position	:	OWNER
Name	:	PAVEL JOSEPH BRAUNSHTEIN
Credential	:
Telephone Number	:	818-590-0433

Provider Enumeration Date	:	05/26/2006
Last Update Date	:	12/10/2010

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Directions to “PAVEL BRAUNSHTEIN ” Practice Location

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