MEDICARE: MRS. ILLUMINADA BETITA M.D.

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	207Q00000X	Family Medicine Physician	C43181	CA

General Provider Information

NPI Number	:	1992742886
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ILLUMINADA BETITA M.D.

Provider Business Mailing Address
First Line	:	1300 N VERMONT AVE
Second Line	:	SUITE 1002
City	:	LOS ANGELES
State	:	CA
Zip	:	90027-6005
Country	:	US
Telephone Number	:	323-953-7341
Fax Number	:	323-953-6244

Provider Business Practice Location Address
First Line	:	4448 YORK BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90041-3328
Country	:	US
Telephone Number	:	323-344-5233
Fax Number	:	323-344-5237

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2006
Last Update Date	:	07/08/2007

Similar Medicare Providers

1447241948 — MS. KATHLEEN P WOOD RN-CFNP
Practice Location Address:

4448 YORK BLVD
LOS ANGELES, CA
90041-3328

Practice Phone: 323-344-5233
Practice Fax: 323-344-5237

1831146174 — MING JACQUELINE LUONG N.P.
Practice Location Address:

4448 YORK BLVD
LOS ANGELES, CA
90041-3328

Practice Phone: 323-344-5233
Practice Fax:

1801967062 — GRACELIGHT COMMUNITY HEALTH
Practice Location Address:

4448 YORK BLVD
LOS ANGELES, CA
90041-3328

Practice Phone: 323-344-5233
Practice Fax: 323-344-5237

1295919090 — CECILIA DIMING WU PHARM D
Practice Location Address:

4448 YORK BLVD.
LOS ANGELES, CA
90041-3328

Practice Phone: 323-702-4856
Practice Fax: 323-344-5237

1881863397 — LONGS DRUG STORES CALIFORNIA LLC
Practice Location Address:

4414 YORK BLVD
LOS ANGELES, CA
90041-3328

Practice Phone: 323-344-4443
Practice Fax: 323-344-4449

1841465721 — DR. DIENAN NHU TRAN D.D.S.
Practice Location Address:

4448 YORK BLVD
LOS ANGELES, CA
90041-3328

Practice Phone: 323-344-5233
Practice Fax:

Directions to “ MRS. ILLUMINADA BETITA M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.