Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | G047826 | CA |
NPI | 1164578977 |
---|---|
Provider Name | Dr. Robert Arman Audell |
First Address | Beverly Hills, CA 90210-3105 |
Second Address | Beverly Hills, CA 90210 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/01/2007 |
Last Update Date | 13/09/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F06974 | (02) | CA |