| Organization Name: | CMC PULMONARY LAB |
| NPI Number: | 1285654640 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ROBERT ROTHBART (PRESIDENT) |
| Mailing Address: | 1401 S Grand Ave Los Angeles |
| State: | CA US |
| Postal Code: | 900153010 |
| Phone Number: | 2137420910 |
| Fax Number: | 2137426631 |
| NPI Enumeration Date: | 07/20/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 293D00000X |
| License Number: | A29402 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Laboratories |
| Taxonomy Classification: | Physiological Laboratory |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A laboratory that operates independently of a hospital and physician |