Provider Demographics
NPI:1528453834
Name:MENASHE EHRENBURG, D.O., APC
Entity type:Organization
Organization Name:MENASHE EHRENBURG, D.O., APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MENASHE
Authorized Official - Middle Name:
Authorized Official - Last Name:EHRENBURG
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:917-596-2555
Mailing Address - Street 1:5232 MARY ELLEN AVE
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91401-6028
Mailing Address - Country:US
Mailing Address - Phone:917-596-2555
Mailing Address - Fax:
Practice Address - Street 1:5232 MARY ELLEN AVE
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91401-6028
Practice Address - Country:US
Practice Address - Phone:917-596-2555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-02
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A11076207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty