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Organization
LA BREA MEDICAL CLINIC PAIN MANAGEMENT, INC
Active
Organization
LA BREA MEDICAL CLINIC PAIN MANAGEMENT, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LESLIE D. PAUL M.D. (OWNER)
(310) 558-8600
Entity
Organization
Contact information
Practice address
3831 HUGHES AVE, 705, CULVER CITY, CA 90232-2751
(310) 558-8600
(310) 558-8650
Mailing address
3831 HUGHES AVE, 705, CULVER CITY, CA 90232-2751
(310) 558-8600
(310) 558-8650
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
G61506
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
OOG615060
—
CA
Enumeration date
03/25/2010
Last updated
03/25/2010
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