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NPI Code Detail

MEDICARE: MAX BLUM

MEDICARE: MAX BLUM
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1992325211
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAX BLUM
Provider Business Mailing Address
First Line : 11150 W OLYMPIC BLVD STE 1160
Second Line :
City : LOS ANGELES
State : CA
Zip : 90064-1826
Country : US
Telephone Number : 424-559-5300
Fax Number : 818-671-2774
Provider Business Practice Location Address
First Line : 11150 W OLYMPIC BLVD STE 1160
Second Line :
City : LOS ANGELES
State : CA
Zip : 90064-1826
Country : US
Telephone Number : 424-559-5300
Fax Number : 818-671-2774
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/17/2020
Last Update Date : 04/17/2020

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Directions to “ MAX BLUM ” Practice Location

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