1023101557

Everything you always wanted to know about GRUSHKIN MAYER CARL M.D. but were afraid to ask.

GRUSHKIN MAYER CARL M.D.

You can also download the this 1023101557 data report as csv | excel | json | xml
Provider Last Name Provider Middle Name Provider First Name Provider Credential
GRUSHKIN MAYER CARL M.D.
Gender:
Male
Enumeration date:
2006-10-02
Last update date:
2008-05-14
Current as of:
Is sole proprietor?:
No
Is organization subpart?:
No
In PECOS?:
Yes
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Identifiers

identifier description issuer state
00G138850G07 Other CALOPTIMA CA
00G138850 Medicaid none CA
A39110 Medicare UPIN none CA
WG19885A Medicare ID-Type Undpecified none CA

Taxonomies

Taxonomy State License Number Primary?
2080P0210X Pediatric Nephrology CA G13885 Y

Phone Numbers

Type Number
Mailing Address Telephone Number 3233612337
Mailing Address Fax Number 3233618491
Practice Location Address Telephone Number 3233612102
Practice Location Address Fax Number 3233611829

Addresses

Type Address City State Postal Country
Mailing Address 6430 SUNSET BLVD. MS# 40 LOS ANGELES CA 90028 CA
Practice Location Address 4650 SUNSET BLVD. SUITE 600 LOS ANGELES CA 0 CA

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