| Doctor Name: | DR. NATHAN D FORD |
| NPI Number: | 1427363985 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | A122580 |
| Business Practice Address: | 7901 Santa Monica Blvd Suite 209 West Hollywood, CA - 900465180 |
| Business Phone Number: | 8443927844 |
| Business Fax Number: | 3239526845 |
| Mailing Address: | 7901 Santa Monica Blvd, Suite 209 WEST HOLLYWOOD |
| State: | CA |
| Postal Code: | 900465177 |
| Phone Number: | 8443927844 |
| Fax Number: | 3239526845 |
| NPI Enumeration Date: | 08/09/2010 |
| NPI Last Update Date: | 04/15/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | A122580 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |