Basic Information
| Provider Information | |||||||||
| NPI: | 1902825045 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | AVROM GART, M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 444 S SAN VICENTE BLVD | ||||||||
| Address2: | SUITE 800 | ||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900484165 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3104239900 | ||||||||
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| Practice Location | |||||||||
| Address1: | 125 EUCALYPTUS DR | ||||||||
| Address2: | |||||||||
| City: | EL SEGUNDO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 902453839 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3103224278 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/19/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | GART | ||||||||
| AuthorizedOfficialFirstName: | AVROM | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 3104239900 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2081P2900X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | Pain Medicine |
No ID Information.