Organization
BEN TAUB MEDICAL INSTITUTE
Active
Parent organization
MARTIN P GRAUMANN MD
Other names
BEN TAUB INSTITUTE
Organization subpart
Yes
Provider details
NPI number
Legal business name
MARTIN P GRAUMANN MD
Authorized official
DR. MARTIN PANCZEL GRAUMANN MD (MANAGING DEIRECTOR - MEMBER)
(818) 270-6491
Entity
Organization
Contact information
Practice address
16055 VENTURA BLVD STE 1120, ENCINO, CA 91436-2612
(818) 270-6491
Mailing address
16055 VENTURA BLVD STE 1120, ENCINO, CA 91436-2612
(818) 270-6491
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
A47960
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1558603944
—
CA
Enumeration date
03/24/2013
Last updated
03/24/2013
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