Organization
MAURICE GOURDJI MD INC & LUCIEN R JACOBS MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAURICE GOURDJI M.D. (GENERAL PARTNER)
(818) 708-6070
Entity
Organization
Contact information
Practice address
18425 BURBANK BLVD, SUITE 500, TARZANA, CA 91356-2806
(818) 708-6070
(818) 708-6075
Mailing address
18425 BURBANK BLVD, SUITE 500, TARZANA, CA 91356-2806
(818) 708-6070
(818) 708-6075
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CP6258
RAILROAD MEDICARE
—
Enumeration date
12/21/2005
Last updated
04/04/2008
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