Screenland Medical Partnership

Primary specialty

Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X

License

A83674 Issued in CA

Legal business name

SCREENLAND MEDICAL PARTNERSHIP

Practice address

3831 Hughes Ave
Suite 504
Culver City, CA 90232-2751

Phone

(310) 204-4111

Fax

(310) 204-4474

NPI assigned

Jun 2, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Michelle Putnam, M.D.

Title

Partner

Phone

(310) 204-4111

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1243900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243900800000",
    "number": "1134355357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3831 HUGHES AVE",
            "address_2": "SUITE 504",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902322751",
            "telephone_number": "310-204-4111",
            "fax_number": "310-204-4474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3831 HUGHES AVE",
            "address_2": "SUITE 504",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902322751",
            "telephone_number": "310-204-4111",
            "fax_number": "310-204-4474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCREENLAND MEDICAL PARTNERSHIP",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-02",
        "last_updated": "2009-06-02",
        "status": "A",
        "authorized_official_last_name": "PUTNAM",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "310-204-4111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207YX0905X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "CA",
            "license": "A83674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Otolaryngology/Facial Plastic Surgery Physician in Culver City, CA
• Providers in Culver City, CA by specialty
• Otolaryngology/Facial Plastic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2009; 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.