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3545 Wilshire Blvd Los Angeles CA 90010-2388 | |
(310) 628-9512 | |
(818) 804-4043 |
Full Name | |
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Speciality | Clinic/center |
Location | 3545 Wilshire Blvd, Los Angeles, California |
Authorized Official Name and Position | Edna Elizabeth Miller (PRESIDENT) |
Authorized Official Contact | 3106289512 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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19300 Rinaldi St Suite 8270 Northridge CA 91326-1651 Ph: (310) 628-9512 | 3545 Wilshire Blvd Los Angeles CA 90010-2388 Ph: (310) 628-9512 |
NPI Number | 1457398539 |
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Provider Enumeration Date | 05/31/2006 |
Last Update Date | 03/03/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1457398539 | NPI | - | NPPES |
CMM71096F | Other | CA | MEDI-CAL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | 96000148 (California) | Primary |
Joseph I Kang Md Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3755 Beverly Blvd, Ste 301, Los Angeles, CA 90004 Phone: 323-664-7777 | |
John L Sherman Md Amc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 8635 W 3rd St Ste 485w, Los Angeles, CA 90048 Phone: 310-855-8081 Fax: 310-855-0438 | |
Altamed Health Services Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5425 Pomona Blvd, Los Angeles, CA 90022 Phone: 323-832-7527 Fax: 323-832-7599 | |