| Ucla Entertainment Ind Medgrp | |
|
23861 Mcbean Pkwy Ste E24 Valencia CA 91355-4457 | |
| (661) 284-3100 | |
| (661) 290-3310 |
| Full Name | Ucla Entertainment Ind Medgrp |
|---|---|
| Speciality | Durable Medical Equipment & Medical Supplies |
| Location | 23861 Mcbean Pkwy Ste E24, Valencia, California |
| Authorized Official Name and Position | Katherine A Hale (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 3103015311 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ucla Entertainment Ind Medgrp 5767 W Century Blvd 400 Los Angeles CA 90045-5631 Ph: (310) 301-8707 | Ucla Entertainment Ind Medgrp 23861 Mcbean Pkwy Ste E24 Valencia CA 91355-4457 Ph: (661) 284-3100 |
| NPI Number | 1770979171 |
|---|---|
| Provider Enumeration Date | 04/13/2015 |
| Last Update Date | 09/21/2020 |
| Medicare PECOS PAC ID | 5294958815 |
|---|---|
| Medicare Enrollment ID | O20150730013757 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770979171 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (California) | Secondary |
| 332B00000X | Durable Medical Equipment & Medical Supplies | (* (Not Available)) | Primary |
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