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Organization
VENICE NEWBURY MEDICAL CLINIC
Active
Organization
VENICE NEWBURY MEDICAL CLINIC
Active
Parent organization
CUTHBERT WESTON PYNE M.D.
Organization subpart
Yes
Provider details
NPI number
Legal business name
CUTHBERT WESTON PYNE M.D.
Authorized official
DR. CUTHBERT WESTON PYNE MD (PHYSICIAN)
(323) 290-6400
Entity
Organization
Contact information
Practice address
3701 STOCKER ST, SUITE 100, LOS ANGELES, CA 90008-5108
(323) 290-6400
(323) 290-6403
Mailing address
PO BOX 45407, LOS ANGELES, CA 90045-0407
(323) 290-6400
(323) 290-6403
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A29958
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A299581
—
CA
01
—
ZZZ01166Z
BLUE SHIELD
CA
Enumeration date
08/14/2007
Last updated
11/13/2012
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