# BENJAMIN BROUKHIM M.D. A MEDICAL CORP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962659151
- **Authorized official:** DR. BENJAMIN BROUKHIM M.D. (MEDICAL DIRECTOR)
- **Authorized official phone:** (818) 755-6070

## Contact information

- **Practice address:** 11650 RIVERSIDE DR, SECOND FLOOR, NORTH HOLLYWOOD, CA 91602-1093
- **Practice address phone:** (818) 755-6070
- **Practice address fax:** (818) 755-1870
- **Mailing address:** 11650 RIVERSIDE DR, SECOND FLOOR, NORTH HOLLYWOOD, CA 91602-1093
- **Mailing address phone:** (818) 755-6070
- **Mailing address fax:** (818) 755-1870

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | A37198 | CA | Yes |

## Other

- **Enumeration date:** 08/19/2008
- **Last updated:** 08/29/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00A37198 | — | CA |