Enhanced Care Rx Clinic, Inc. | |
266 S Harvard Blvd Ste 120a Los Angeles CA 90004-4374 | |
(213) 527-2995 | |
(213) 527-2996 |
Full Name | Enhanced Care Rx Clinic, Inc. |
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Speciality | Clinic/Center |
Location | 266 S Harvard Blvd Ste 120a, Los Angeles, California |
Authorized Official Name and Position | Sang Jung Lee (CEO) |
Authorized Official Contact | 2135272995 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Enhanced Care Rx Clinic, Inc. Po Box 741330 Los Angeles CA 90004-9330 Ph: (213) 527-2995 | Enhanced Care Rx Clinic, Inc. 266 S Harvard Blvd Ste 120a Los Angeles CA 90004-4374 Ph: (213) 527-2995 |
NPI Number | 1457082794 |
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Provider Enumeration Date | 06/17/2022 |
Last Update Date | 07/18/2022 |
Medicare PECOS PAC ID | 5597148023 |
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Medicare Enrollment ID | O20220817000305 |
Identifier | Type | State | Issuer |
---|---|---|---|
1457082794 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
Provider Name | Laura Purdy |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1093058463 PECOS PAC ID: 9133556624 Enrollment ID: I20200403001862 |
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