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Organization

ROBERT P. WALDMAN, M.D. A PROFESSIONAL CORPORATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ROBERT P. WALDMAN M.D. (PRESIDENT)
(310) 301-0015
Entity
Organization

Contact information

Practice address
4644 LINCOLN BLVD, STE 540, MARINA DEL REY, CA 90292-6313
(310) 301-0015
(310) 901-5821
Mailing address
4644 LINCOLN BLVD, STE 540, MARINA DEL REY, CA 90292-6313
(310) 301-0015
(310) 901-5821

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
G49826
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1487689329
INDIVIDUAL NPI
CA
01
G49826
PTAN
CA
Enumeration date
11/18/2010
Last updated
11/18/2010
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