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NPI Code Detail

MEDICARE: HEALTH ATLAST WEST LA INC

MEDICARE: HEALTH ATLAST WEST LA 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
1207R00000XInternal Medicine Physician
2208100000XPhysical Medicine & Rehabilitation PhysicianA99205CA

General Provider Information

NPI Number : 1376968610
Entity Type Code : Organization
Provider Name (Legal Business Name) : HEALTH ATLAST WEST LA INC
Provider Business Mailing Address
First Line : 3030 SAWTELLE BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90066-1408
Country : US
Telephone Number : 310-390-9018
Fax Number : 310-390-0868
Provider Business Practice Location Address
First Line : 3030 SAWTELLE BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90066-1408
Country : US
Telephone Number : 310-390-9018
Fax Number : 310-390-0868
Authorized Official
Title or Position : PRESIDENT
Name : WAYNE EICHI HIGASHI
Credential : DC
Telephone Number : 310-390-9018
Provider Enumeration Date : 02/24/2014
Last Update Date : 03/11/2026

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Directions to “HEALTH ATLAST WEST LA INC ” Practice Location

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