Individual
BARTON TANENBAUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
201 S ALVARADO ST, SUITE 215, LOS ANGELES, CA 90057-2320
(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
05
—
00G129500
—
CA
05
—
00G192501
—
CA
01
—
0385570001
MEDICARE DME
CA
01
—
0385570002
MEDICARE DME
CA
01
—
340018176
RR MEDICARE
CA
01
—
341916018
RR MEDICARE
CA
05
—
LAB94467F
—
CA
Enumeration date
05/03/2006
Last updated
06/12/2019
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