Doctor Name: | DR. ROY B BLUMENSTRAUCH |
NPI Number: | 1639175409 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | G54548 |
Business Practice Address: | 4201 Torrance Blvd Ste 640 Torrance, CA - 905034504 |
Business Phone Number: | 3105434444 |
Business Fax Number: | 3105434446 |
Mailing Address: | 4201 Torrance Blvd, Ste 640 TORRANCE |
State: | CA |
Postal Code: | 905034504 |
Phone Number: | 3105434444 |
Fax Number: | 3105434446 |
NPI Enumeration Date: | 06/24/2005 |
NPI Last Update Date: | 11/27/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | 03/16/2006 |
NPI Reactivation Date: | 04/05/2006 |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | G54548 |
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. |