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NPI Code Detail

MEDICARE: DR. JULIE G MADORSKY MD

MEDICARE: DR. JULIE G MADORSKY MD
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
1208100000XPhysical Medicine & Rehabilitation PhysicianG27202CA

General Provider Information

NPI Number : 1881686236
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JULIE G MADORSKY MD
Provider Business Mailing Address
First Line : 4445 BERGAMO DR
Second Line :
City : ENCINO
State : CA
Zip : 91436-3305
Country : US
Telephone Number : 818-783-5617
Fax Number :
Provider Business Practice Location Address
First Line : 309 E 2ND ST
Second Line :
City : POMONA
State : CA
Zip : 91766-1854
Country : US
Telephone Number : 909-623-6116
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/20/2005
Last Update Date : 07/08/2007

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