Ralph Potkin MD a Medical Corp

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

RALPH POTKIN MD A MEDICAL CORP

Practice address

1125 S Beverly Dr
Suite 406
Los Angeles, CA 90035-1148

Phone

(310) 551-1178

Fax

(310) 551-2047

NPI assigned

Feb 13, 2007

Organization subpart

No

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

Authorized official

Name

Ralph T Potkin, MD

Title

President

Phone

(310) 551-1178

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1385078400000",
    "number": "1215079751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 S BEVERLY DR",
            "address_2": "SUITE 406",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900351148",
            "telephone_number": "310-551-1178",
            "fax_number": "310-551-2047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 S BEVERLY DR",
            "address_2": "SUITE 406",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900351148",
            "telephone_number": "310-551-1178",
            "fax_number": "310-551-2047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RALPH POTKIN MD A MEDICAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2013-11-22",
        "status": "A",
        "authorized_official_last_name": "POTKIN",
        "authorized_official_first_name": "RALPH",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-551-1178",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0069770",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle Rakovsky
• Antonio Ralac
• Monica Ralda
• Ann Raldow, M.D.
• Ralph a Callender DDS Corp.
• Ralph Watchi, MD a Professional Corporation
• Janet Ralph
• Jessica Michelle Ralph
• Mark William Ralph, MD
• Ralphs Grocery Company

• Medical Specialty Clinic/Center in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Medical Specialty Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2013; 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.