| Regent Specialists Medical Clinic | |
|
3701 Stocker St Suite 100 Los Angeles CA 90008-5108 | |
| (323) 296-6942 | |
| (323) 299-1651 |
| Full Name | Regent Specialists Medical Clinic |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 3701 Stocker St, Los Angeles, California |
| Authorized Official Name and Position | Ivor H. Harewood (PRESIDENT) |
| Authorized Official Contact | 3232966942 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Regent Specialists Medical Clinic Po Box 8387 Los Angeles CA 90008-0387 Ph: (323) 296-6942 | Regent Specialists Medical Clinic 3701 Stocker St Suite 100 Los Angeles CA 90008-5108 Ph: (323) 296-6942 |
| NPI Number | 1073729497 |
|---|---|
| Provider Enumeration Date | 05/15/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073729497 | NPI | - | NPPES |
| 00G233110 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | G23311 (California) | Primary |
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