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318 Lincoln Blvd, Suite 225, Venice, CA 90291-2827 | |
(310) 396-3635 | |
Not Available |
Full Name | |
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Type | Facility |
Speciality | Internal Medicine |
Location | 318 Lincoln Blvd, Venice, California |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
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1295977437 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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111N00000X | Chiropractor | 25498 (California) | Secondary |
207R00000X | Internal Medicine | A91752 (California) | Primary |
Mailing Address | Practice Location Address |
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318 Lincoln Blvd, Suite 225, Venice, CA 90291-2827 Ph: (310) 396-3635 | 318 Lincoln Blvd, Suite 225, Venice, CA 90291-2827 Ph: (310) 396-3635 |