Provider Demographics
NPI:1114099744
Name:UROLOGY ASSOCIATES MEDICAL GROUP
Entity Type:Organization
Organization Name:UROLOGY ASSOCIATES MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:
Authorized Official - Last Name:WEINTRAUB
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-843-1700
Mailing Address - Street 1:2601 W ALAMEDA AVE
Mailing Address - Street 2:SUITE 416
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505
Mailing Address - Country:US
Mailing Address - Phone:818-843-1700
Mailing Address - Fax:818-843-0380
Practice Address - Street 1:2601 W ALAMEDA AVE
Practice Address - Street 2:SUITE 416
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505
Practice Address - Country:US
Practice Address - Phone:818-843-1700
Practice Address - Fax:818-843-0380
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2018-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty