Organization
BARTON TANENBAUM MD A MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BARTON TANENBAUM MD (A MEDICAL CORPORATIONPRESIDENT)
(310) 278-2970
Entity
Organization
Contact information
Practice address
1127 WILSHIRE BLVD STE 805, LOS ANGELES, CA 90017-3909
(213) 484-9900
(213) 484-0158
Mailing address
1127 WILSHIRE BLVD STE 805, LOS ANGELES, CA 90017-3909
(213) 484-9900
(213) 484-0158
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
G19250
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005G192501
BLUE SHIELD
CA
05
—
00G129501
—
CA
01
—
00G192500
BLUE SHIELD
—
05
—
00G192500
—
CA
01
—
340018176
RAILROAD MEDICARE
CA
01
—
341916018
RAILROAD MEDICARE
—
05
—
LAB94467F
—
CA
Enumeration date
11/22/2006
Last updated
06/26/2019
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