| Via Avanta | |
|
4760 Sepulveda Blvd Culver City CA 90230 | |
| (310) 390-6612 | |
| Not Available |
| Full Name | Via Avanta |
|---|---|
| Speciality | Clinic/center - Community Health |
| Location | 4760 Sepulveda Blvd, Culver City, California |
| Authorized Official Name and Position | Mayli Eunice Torres (ASSISTANT COUNSLER) |
| Authorized Official Contact | 8185619415 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Via Avanta 4760 Sepulveda Blvd Culver City CA 90230 Ph: (310) 390-6612 | Via Avanta 4760 Sepulveda Blvd Culver City CA 90230 Ph: (310) 390-6612 |
| NPI Number | 1639610462 |
|---|---|
| Provider Enumeration Date | 03/13/2017 |
| Last Update Date | 03/13/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639610462 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | 172V00000X (California) | Primary |
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