Los Angeles Multispecialty Medical Group | |
248 N Locust St Inglewood CA 90301-1258 | |
(310) 680-1810 | |
(310) 680-1811 |
Full Name | Los Angeles Multispecialty Medical Group |
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Speciality | Internal Medicine - Nephrology |
Location | 248 N Locust St, Inglewood, California |
Authorized Official Name and Position | Randall Whitaker Maxey (PRESIDENT) |
Authorized Official Contact | 3106801810 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Los Angeles Multispecialty Medical Group Po Box 83246 Los Angeles CA 90083-0246 Ph: (310) 680-1810 | Los Angeles Multispecialty Medical Group 248 N Locust St Inglewood CA 90301-1258 Ph: (310) 680-1810 |
NPI Number | 1528113149 |
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Provider Enumeration Date | 01/24/2007 |
Last Update Date | 03/25/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1528113149 | NPI | - | NPPES |
C30814 | Other | CA | MED LICENCE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | C38014 (California) | Secondary |
207RN0300X | Internal Medicine - Nephrology | (* (Not Available)) | Primary |
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