Provider Demographics
NPI:1447348909
Name:FRUMOVITZ, MATSUNAGA, DALY, ROSS, THORDARSON, VOGEL, MD'S - A MED CORP
Entity type:Organization
Organization Name:FRUMOVITZ, MATSUNAGA, DALY, ROSS, THORDARSON, VOGEL, MD'S - A MED CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MGR
Authorized Official - Prefix:
Authorized Official - First Name:DOLORES
Authorized Official - Middle Name:J
Authorized Official - Last Name:NIECE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-586-9410
Mailing Address - Street 1:2001 SANTA MONICA BLVD
Mailing Address - Street 2:#970-W
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-2102
Mailing Address - Country:US
Mailing Address - Phone:310-829-7878
Mailing Address - Fax:310-453-5586
Practice Address - Street 1:2001 SANTA MONICA BLVD
Practice Address - Street 2:#970-W
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-2102
Practice Address - Country:US
Practice Address - Phone:310-829-7878
Practice Address - Fax:310-453-5586
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-10
Last Update Date:2010-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty