Provider Demographics
NPI:1942432091
Name:BOMAMED INC
Entity Type:Organization
Organization Name:BOMAMED INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BOAZ
Authorized Official - Middle Name:
Authorized Official - Last Name:BRIZMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:310-231-3300
Mailing Address - Street 1:2001 S BARRINGTON AVE STE 115
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-5337
Mailing Address - Country:US
Mailing Address - Phone:310-231-3300
Mailing Address - Fax:
Practice Address - Street 1:2001 S. BARRINGTON AVE 115
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025
Practice Address - Country:US
Practice Address - Phone:310-231-3300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-21
Last Update Date:2009-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty