Robert a. Audell, M.D.,Medical Corporation

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

G047826 Issued in CA

Legal business name

ROBERT A. AUDELL, M.D.,MEDICAL CORPORATION

Practice address

8670 Wilshire Blvd Ste 202
Beverly Hills, CA 90211-2930

Phone

(310) 855-0751

Fax

(310) 657-6342

NPI assigned

May 7, 2008

Organization subpart

No

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

Authorized official

Name

Phyllis Wodin

Title

Office Manager

Phone

(310) 432-1401

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1210118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219968000000",
    "number": "1487820601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8670 WILSHIRE BLVD STE 202",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902112930",
            "telephone_number": "310-855-0751",
            "fax_number": "310-657-6342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8670 WILSHIRE BLVD STE 202",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902112930",
            "telephone_number": "310-855-0751",
            "fax_number": "310-657-6342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT A. AUDELL, M.D.,MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-07",
        "last_updated": "2008-08-29",
        "status": "A",
        "authorized_official_last_name": "WODIN",
        "authorized_official_first_name": "PHYLLIS",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "310-432-1401"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": "G047826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Beverly Hills, CA
• Providers in Beverly Hills, CA by specialty
• Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2008; 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.