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4146 E Olympic Blvd Suite B Los Angeles CA 90023-3347 | |
(323) 262-9948 | |
(323) 262-3708 |
Full Name | |
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Speciality | Internal Medicine |
Location | 4146 E Olympic Blvd, Los Angeles, California |
Authorized Official Name and Position | Shura A Moreno (DIRECTOR) |
Authorized Official Contact | 3232629948 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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4146 E Olympic Blvd Suite B Los Angeles CA 90023-3347 Ph: (323) 262-9948 | 4146 E Olympic Blvd Suite B Los Angeles CA 90023-3347 Ph: (323) 262-9948 |
NPI Number | 1417156860 |
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Provider Enumeration Date | 07/16/2007 |
Last Update Date | 07/16/2007 |
Identifier | Type | State | Issuer |
---|---|---|---|
1417156860 | NPI | - | NPPES |
00A780520 | Other | CA | BLUE SHIELD BLUE CROSS |
00A780520 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Joseph I Kang Md Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3755 Beverly Blvd, Ste 301, Los Angeles, CA 90004 Phone: 323-664-7777 | |
John L Sherman Md Amc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 8635 W 3rd St Ste 485w, Los Angeles, CA 90048 Phone: 310-855-8081 Fax: 310-855-0438 | |
Altamed Health Services Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5425 Pomona Blvd, Los Angeles, CA 90022 Phone: 323-832-7527 Fax: 323-832-7599 | |