Provider Demographics
NPI:1124295977
Name:CENTER FOR BREAST CARE, INC.
Entity type:Organization
Organization Name:CENTER FOR BREAST CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DEANNA
Authorized Official - Middle Name:J
Authorized Official - Last Name:ATTAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-243-5640
Mailing Address - Street 1:222 W EULALIA ST STE 315
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91204-2852
Mailing Address - Country:US
Mailing Address - Phone:818-243-5640
Mailing Address - Fax:818-243-6381
Practice Address - Street 1:222 W EULALIA ST STE 315
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91204-2852
Practice Address - Country:US
Practice Address - Phone:818-243-5640
Practice Address - Fax:818-243-6381
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-12
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG8507208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG90829Medicare UPIN