Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | G59372 | CA |
NPI | 1407886583 |
---|---|
Provider Name | Dr. Avrom Gart |
First Address | El Segundo, CA 90245-3915 |
Second Address | Los Angeles, CA 90048-4165 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/07/2006 |
Last Update Date | 24/05/2013 |