MEDICARE: DANIEL B BORENSTEIN, M.D., 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	261QM2500X	Medical Specialty Clinic/Center	0669733	CA

General Provider Information

NPI Number	:	1629277835
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DANIEL B BORENSTEIN, M.D., A MEDICAL CORPORATION

Provider Business Mailing Address
First Line	:	151 N CANYON VIEW DR
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90049-2721
Country	:	US
Telephone Number	:	310-472-7386
Fax Number	:	310-471-0708

Provider Business Practice Location Address
First Line	:	151 N CANYON VIEW DR
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90049-2721
Country	:	US
Telephone Number	:	310-472-7386
Fax Number	:	310-471-0708

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DANIEL B BORENSTEIN
Credential	:	MD
Telephone Number	:	310-472-7386

Provider Enumeration Date	:	07/17/2007
Last Update Date	:	07/17/2007

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