| Lifeway Healthcare Services Inc. | |
|
10024 S Vermont Ave Los Angeles CA 90044-3112 | |
| (323) 242-3888 | |
| (323) 242-1188 |
| Full Name | Lifeway Healthcare Services Inc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 10024 S Vermont Ave, Los Angeles, California |
| Authorized Official Name and Position | Kingsley O Ofoegbu (CEO) |
| Authorized Official Contact | 3232423888 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifeway Healthcare Services Inc. 10024 S Vermont Ave Los Angeles CA 90044-3112 Ph: (323) 242-3888 | Lifeway Healthcare Services Inc. 10024 S Vermont Ave Los Angeles CA 90044-3112 Ph: (323) 242-3888 |
| NPI Number | 1629233523 |
|---|---|
| Provider Enumeration Date | 07/21/2008 |
| Last Update Date | 07/21/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629233523 | NPI | - | NPPES |
| 00A730400 | Medicaid | CA | |
| 1285732354 | Other | CA | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A73040 (California) | Primary |
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