Provider Demographics
NPI:1568686855
Name:IRWIN SAVODNIK, M.D. & MEDICAL ASSOCIATES, INC.
Entity Type:Organization
Organization Name:IRWIN SAVODNIK, M.D. & MEDICAL ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:PSY D
Authorized Official - Phone:310-517-1717
Mailing Address - Street 1:2780 SKYPARK DR STE 260
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-5342
Mailing Address - Country:US
Mailing Address - Phone:310-517-1717
Mailing Address - Fax:310-517-9853
Practice Address - Street 1:555TACHEVAH DR. BLDG. 1 W #105
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262
Practice Address - Country:US
Practice Address - Phone:310-517-1717
Practice Address - Fax:310-517-9853
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 14596103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty