Provider Demographics
NPI:1033416656
Name:RELIANT MEDICAL MANAGEMENT INC
Entity Type:Organization
Organization Name:RELIANT MEDICAL MANAGEMENT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MAX
Authorized Official - Middle Name:
Authorized Official - Last Name:LEBOW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-491-7066
Mailing Address - Street 1:9601 S SEPULVEDA BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-5203
Mailing Address - Country:US
Mailing Address - Phone:310-491-7066
Mailing Address - Fax:
Practice Address - Street 1:9601 S SEPULVEDA BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90045-5203
Practice Address - Country:US
Practice Address - Phone:310-491-7066
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RELIANT MEDICAL MANAGEMENT INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-02-16
Last Update Date:2011-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty