Doctor Name: | ANATOL PODOLSKY |
NPI Number: | 1528178936 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | G71630 |
Business Practice Address: | 400 Newport Center Dr 601 Newport Beach, CA - 926607601 |
Business Phone Number: | 9496446882 |
Business Fax Number: | 9496442377 |
Mailing Address: | 4627 Surrey Dr, CORONA DEL MAR |
State: | CA |
Postal Code: | 926252725 |
Phone Number: | 9496444897 |
Fax Number: | |
NPI Enumeration Date: | 08/30/2006 |
NPI Last Update Date: | 08/17/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | G71630 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |