MEDICARE: CORY A WALDMAN M D A PROFESSIONAL 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	207RC0000X	Cardiovascular Disease Physician
2	261QM1300X	Multi-Specialty Clinic/Center	A1235635	CA

General Provider Information

NPI Number	:	1851730212
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CORY A WALDMAN M D A PROFESSIONAL CORPORATION

Provider Business Mailing Address
First Line	:	435 N ROXBURY DR
Second Line	:	SUITE 300
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90210-5027
Country	:	US
Telephone Number	:	424-239-1499
Fax Number	:

Provider Business Practice Location Address
First Line	:	435 N ROXBURY DR
Second Line	:	SUITE 300
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90210-5027
Country	:	US
Telephone Number	:	424-239-1499
Fax Number	:

Authorized Official
Title or Position	:	MD
Name	:	CORY ADAM WALDMAN
Credential	:	MD
Telephone Number	:	424-239-1499

Provider Enumeration Date	:	06/19/2013
Last Update Date	:	06/03/2022

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Directions to “CORY A WALDMAN M D A PROFESSIONAL CORPORATION ” Practice Location

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