MEDICARE: AMERICAN MILLENNIUM ANGELS, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1013347350
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMERICAN MILLENNIUM ANGELS, INC.

Provider Business Mailing Address
First Line	:	3424 WILSHIRE BLVD
Second Line	:	SUITE 1112
City	:	LOS ANGELES
State	:	CA
Zip	:	90010-2263
Country	:	US
Telephone Number	:	323-456-5047
Fax Number	:	323-456-5053

Provider Business Practice Location Address
First Line	:	3424 WILSHIRE BLVD
Second Line	:	SUITE 1112
City	:	LOS ANGELES
State	:	CA
Zip	:	90010-2263
Country	:	US
Telephone Number	:	323-456-5047
Fax Number	:	323-456-5053

Authorized Official
Title or Position	:	DPCS
Name	:	MISS LEILA G VILLON
Credential	:	RN
Telephone Number	:	323-456-5047

Provider Enumeration Date	:	11/23/2013
Last Update Date	:	11/23/2013

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