Provider Demographics
NPI:1073548681
Name:TOWER PULMONARY ASSOCIATES A MED GROUP
Entity Type:Organization
Organization Name:TOWER PULMONARY ASSOCIATES A MED GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:K
Authorized Official - Last Name:ROTHBART
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:213-742-0910
Mailing Address - Street 1:1400 S GRAND AVE STE 605
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90015-3068
Mailing Address - Country:US
Mailing Address - Phone:213-742-0910
Mailing Address - Fax:213-742-6631
Practice Address - Street 1:1400 S GRAND AVE STE 605
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90015-3068
Practice Address - Country:US
Practice Address - Phone:213-742-0910
Practice Address - Fax:213-742-6631
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2015-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA29402207R00000X
CAG32106207R00000X
CAG24071207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
A45010Medicare UPIN
A90854Medicare UPIN
A25745Medicare UPIN