| La Brea Medical Clinic Pain Management, Inc | |
|
3831 Hughes Ave 705 Culver City CA 90232-2751 | |
| (310) 558-8600 | |
| (310) 558-8650 |
| Full Name | La Brea Medical Clinic Pain Management, Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 3831 Hughes Ave, Culver City, California |
| Authorized Official Name and Position | Leslie D. Paul (OWNER) |
| Authorized Official Contact | 3105588600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| La Brea Medical Clinic Pain Management, Inc 3831 Hughes Ave 705 Culver City CA 90232-2751 Ph: (310) 558-8600 | La Brea Medical Clinic Pain Management, Inc 3831 Hughes Ave 705 Culver City CA 90232-2751 Ph: (310) 558-8600 |
| NPI Number | 1871817460 |
|---|---|
| Provider Enumeration Date | 03/25/2010 |
| Last Update Date | 03/25/2010 |
| Medicare PECOS PAC ID | 2264560713 |
|---|---|
| Medicare Enrollment ID | O20100505000010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871817460 | NPI | - | NPPES |
| OOG615060 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | G61506 (California) | Primary |
| Provider Name | Leslie D Paul |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366509499 PECOS PAC ID: 8921185737 Enrollment ID: I20100505000035 |
Lowell P Theard Md Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3831 Hughes Ave, 705, Culver City, CA 90232 Phone: 310-838-6801 Fax: 310-838-5385 | |
Jefferson West Medical Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4212 Overland Ave, Culver City, CA 90230 Phone: 310-204-2574 Fax: 310-204-2820 | |
Martha Sonnenberg Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3831 Hughes Ave, Suite 702, Culver City, CA 90232 Phone: 310-659-4384 Fax: 310-659-9342 | |
Achievable Health Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5901 Green Valley Cir, Suite 405, Culver City, CA 90230 Phone: 424-266-7474 Fax: 310-596-8268 | |
Daniel V. Ehrensaft, Md A Professional Corp. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3831 Hughes Ave, Suite 603, Culver City, CA 90232 Phone: 310-202-9145 Fax: 310-202-0188 | |
Nadiya Ginzburg Md Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3831 Hughes Ave Ste 604, Culver City, CA 90232 Phone: 310-842-8988 Fax: 310-842-8953 | |
Prospera Group Corp Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3831 Hughes Ave, Suite 602, Culver City, CA 90232 Phone: 310-204-6897 Fax: 310-204-4690 |