MEDICARE: DR. EDUARDO BESSER 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	207W00000X	Ophthalmology Physician	A79263	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1972561280
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EDUARDO BESSER M.D.

Provider Business Mailing Address
First Line	:	11740 WILSHIRE BLVD
Second Line	:	#A1006
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-6536
Country	:	US
Telephone Number	:	310-560-9845
Fax Number	:	310-646-6256

Provider Business Practice Location Address
First Line	:	9808 VENICE BLVD
Second Line	:	#400
City	:	CULVER CITY
State	:	CA
Zip	:	90232-2732
Country	:	US
Telephone Number	:	310-838-0202
Fax Number	:	310-464-6256

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

Provider Enumeration Date	:	05/03/2006
Last Update Date	:	05/12/2011

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