Provider Demographics
NPI:1689862732
Name:ISRAEL GORINSTEIN M.D., INC
Entity Type:Organization
Organization Name:ISRAEL GORINSTEIN M.D., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL / LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:GORINSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-931-1100
Mailing Address - Street 1:PO BOX 480560
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-1560
Mailing Address - Country:US
Mailing Address - Phone:323-931-1100
Mailing Address - Fax:323-930-1354
Practice Address - Street 1:5901 W OLYMPIC BLVD
Practice Address - Street 2:SUITE 203
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90036-4667
Practice Address - Country:US
Practice Address - Phone:323-931-1100
Practice Address - Fax:323-930-1354
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-12
Last Update Date:2014-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA35991261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty