Erie V Boorman MD Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

ERIE V BOORMAN MD INC

Practice address

11645 Wilshire Blvd
Suite 901
Los Angeles, CA 90025-1708

Phone

(310) 481-0481

NPI assigned

Sep 14, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Erie V Boorman, MD

Title

President

Phone

(310) 481-0481

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1189728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189728000000",
    "number": "1053507897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11645 WILSHIRE BLVD",
            "address_2": "SUITE 901",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900251708",
            "telephone_number": "310-481-0481",
            "fax_number": "310-481-0482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11645 WILSHIRE BLVD",
            "address_2": "SUITE 901",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900251708",
            "telephone_number": "310-481-0481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERIE V BOORMAN MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-14",
        "last_updated": "2007-09-14",
        "status": "A",
        "authorized_official_last_name": "BOORMAN",
        "authorized_official_first_name": "ERIE",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-481-0481",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.