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Organization
RWSUDA-ASHURWITZ MEDICAL CORP
Active
Organization
RWSUDA-ASHURWITZ MEDICAL CORP
Active
Other names
RWSuda-ASHurwitz Medical Corp
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DIANE JAYE CONNER (BOOKKEEPER)
(818) 244-4374
Entity
Organization
Contact information
Practice address
1510 S CENTRAL AVE, SUITE 530, GLENDALE, CA 91204-2500
(818) 244-4374
(818) 244-0633
Mailing address
1510 S CENTRAL AVE, SUITE 530, GLENDALE, CA 91204-2500
(818) 244-4374
(818) 244-0633
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
A60385
CA
174400000X
Specialist
Primary
G53084
CA
174400000X
Specialist
G75481
CA
Other
Enumeration date
02/14/2007
Last updated
08/22/2020
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