MEDICARE: JUDITH REICHMAN 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	207VG0400X	Gynecology Physician	A35620	CA

General Provider Information

NPI Number	:	1396740908
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUDITH REICHMAN M.D.

Provider Business Mailing Address
First Line	:	2080 CENTURY PARK E
Second Line	:	1009
City	:	LOS ANGELES
State	:	CA
Zip	:	90067-2001
Country	:	US
Telephone Number	:	310-659-9690
Fax Number	:	310-277-9690

Provider Business Practice Location Address
First Line	:	2080 CENTURY PARK E
Second Line	:	1009
City	:	LOS ANGELES
State	:	CA
Zip	:	90067-2001
Country	:	US
Telephone Number	:	310-659-9690
Fax Number	:	310-277-9690

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

Provider Enumeration Date	:	06/20/2005
Last Update Date	:	09/28/2012

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