Organization
R. PAUL ST. AMAND, M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROGER P. ST. AMAND M.D. (PRESIDENT)
(310) 577-7510
Entity
Organization
Contact information
Practice address
4560 ADMIRALTY WAY, STE. 355, MARINA DEL REY, CA 90292-5423
(310) 577-7510
(310) 821-0664
Mailing address
4560 ADMIRALTY WAY, STE. 355, MARINA DEL REY, CA 90292-5423
(310) 577-7510
(310) 821-0664
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
G2487
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0006G24870
BLUECROSS BLUE SHIELD
CA
Enumeration date
08/03/2010
Last updated
08/03/2010
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