Provider Demographics
NPI:1013016013
Name:TOWER CENTER EAR NOSE & THROAT
Entity Type:Organization
Organization Name:TOWER CENTER EAR NOSE & THROAT
Other - Org Name:CORPORATION
Other - Org Type:Other Name
Authorized Official - Title/Position:MEDICAL DIRECTOR OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:HOPP
Authorized Official - Suffix:
Authorized Official - Credentials:MD PHD
Authorized Official - Phone:310-657-7704
Mailing Address - Street 1:8631 W 3RD ST
Mailing Address - Street 2:SUITE 440 EAST
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048
Mailing Address - Country:US
Mailing Address - Phone:310-657-7704
Mailing Address - Fax:310-652-9906
Practice Address - Street 1:8631 W 3RD ST
Practice Address - Street 2:SUITE 440 EAST
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048
Practice Address - Country:US
Practice Address - Phone:310-657-7704
Practice Address - Fax:310-652-9906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
H38785Medicare UPIN
A40196Medicare UPIN
A47122Medicare UPIN