Individual
EMANUEL MAIDENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
300 MEDICAL PLZ, LOS ANGELES, CA 90095-0001
(310) 825-9989
Mailing address
5767 W CENTURY BLVD, SUITE 200, LOS ANGELES, CA 90045-5632
(310) 825-9989
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
PSY14789
CA
103TC0700X
Clinical Psychologist
Primary
PSY14789
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PSY147890
—
CA
Enumeration date
07/08/2006
Last updated
07/17/2024
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