Individual
DR. GEORGE P. TEITELBAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2121 SANTA MONICA BLVD, SANTA MONICA, CA 90404-2303
(310) 829-8319
(310) 582-7495
Mailing address
501 S BUENA VISTA ST, PROVIDENCE NEUROVASCULAR CENTER, BURBANK, CA 91505-4809
(818) 847-4835
(818) 847-4842
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
G45097
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G450970
BC/BS
CA
05
—
00G450970
—
CA
05
—
1982645602
—
CA
Enumeration date
06/10/2006
Last updated
01/25/2024
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