Provider Demographics
NPI:1497865851
Name:AVIVA D BIEDERMAN MD INC
Entity Type:Organization
Organization Name:AVIVA D BIEDERMAN MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AVIVA
Authorized Official - Middle Name:DUNKELMAN
Authorized Official - Last Name:BIEDERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-652-3324
Mailing Address - Street 1:8635 W 3RD ST
Mailing Address - Street 2:SUITE 260W
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-6101
Mailing Address - Country:US
Mailing Address - Phone:310-652-3324
Mailing Address - Fax:310-652-2389
Practice Address - Street 1:8635 W 3RD ST
Practice Address - Street 2:SUITE 260W
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-6101
Practice Address - Country:US
Practice Address - Phone:310-652-3324
Practice Address - Fax:310-652-2389
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA25756208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty