Healthcare Provider Details

I. General information

NPI: 1609536747
Provider Name (Legal Business Name): OAKHURST CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2021
Last Update Date: 12/29/2021
Certification Date: 12/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9150 WILSHIRE BLVD STE 101
BEVERLY HILLS CA
90212-3433
US

IV. Provider business mailing address

9150 WILSHIRE BLVD STE 101
BEVERLY HILLS CA
90212-3433
US

V. Phone/Fax

Practice location:
  • Phone: 310-402-8996
  • Fax:
Mailing address:
  • Phone: 310-402-8996
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DANIELLA NEWMAN
Title or Position: PRESIDENT
Credential: D.O.
Phone: 310-402-8996