Potkin, Ralph Terry

Potkin, Ralph Terry is an sole proprietor health care provider with primary practice located at 1125 S Beverly Dr #406, La CA 90035. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Potkin, Ralph Terry can be contacted via phone (310) 551-1178.

Contact Information

Primary practice address
1125 S Beverly Dr #406 La CA 90035
Fax: (310) 551-2047
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X G38416 California

Profile Details

NPI number 1710043096
LBN Legal business name Potkin, Ralph Terry
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 29th, 2006
Last updated Jul 16th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710043096 NPPES
California MEDICAID 00G384160

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