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Organization
RALPH POTKIN MD A MEDICAL CORP
Active
Organization
RALPH POTKIN MD A MEDICAL CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RALPH T POTKIN MD (PRESIDENT)
(310) 551-1178
Entity
Organization
Contact information
Practice address
1125 S BEVERLY DR, SUITE 406, LOS ANGELES, CA 90035-1148
(310) 551-1178
(310) 551-2047
Mailing address
1125 S BEVERLY DR, SUITE 406, LOS ANGELES, CA 90035-1148
(310) 551-1178
(310) 551-2047
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0069770
—
CA
Enumeration date
02/13/2007
Last updated
11/22/2013
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