MEDICARE: MEDOPS LLC

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	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1184433369
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDOPS LLC

Provider Business Mailing Address
First Line	:	4525 EAGLE ROCK BLVD
Second Line	:
City	:	EAGLE ROCK
State	:	CA
Zip	:	90041-3214
Country	:	US
Telephone Number	:	818-846-4469
Fax Number	:

Provider Business Practice Location Address
First Line	:	4525 EAGLE ROCK BLVD
Second Line	:
City	:	EAGLE ROCK
State	:	CA
Zip	:	90041-3214
Country	:	US
Telephone Number	:	818-846-4469
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	TED BONZON
Credential	:	LCSW
Telephone Number	:	818-846-4469

Provider Enumeration Date	:	01/02/2025
Last Update Date	:	01/02/2025

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Directions to “MEDOPS LLC ” Practice Location

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