| Ladera Medical Practice Inc | |
|
5141 Crenshaw Blvd Los Angeles CA 90043-1853 | |
| (323) 545-9288 | |
| (323) 545-9287 |
| Full Name | Ladera Medical Practice Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 5141 Crenshaw Blvd, Los Angeles, California |
| Authorized Official Name and Position | Deedee Weston (DIRECTOR) |
| Authorized Official Contact | 3235459288 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ladera Medical Practice Inc 5141 Crenshaw Blvd Los Angeles CA 90043-1853 Ph: (323) 545-9288 | Ladera Medical Practice Inc 5141 Crenshaw Blvd Los Angeles CA 90043-1853 Ph: (323) 545-9288 |
| NPI Number | 1689849481 |
|---|---|
| Provider Enumeration Date | 04/23/2008 |
| Last Update Date | 03/27/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689849481 | NPI | - | NPPES |
| 00A630290 | Medicaid | CA | |
| 00G459770 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (California) | Primary |
| 2086S0127X | Surgery - Trauma Surgery | (California) | Secondary |
| 208D00000X | General Practice | (California) | Secondary |
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