Healthcare Provider Details

I. General information

NPI: 1942594742
Provider Name (Legal Business Name): LOEW VISION REHABILITATION INSTITUTE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2011
Last Update Date: 06/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

239 SOUTH LA CIENEGA BLVD SUITE 100
BEVERLY HILLS CA
90211-3319
US

IV. Provider business mailing address

239 SOUTH LA CIENEGA BLVD SUITE 100
BEVERLY HILLS CA
90211-3319
US

V. Phone/Fax

Practice location:
  • Phone: 310-553-0100
  • Fax: 424-288-4893
Mailing address:
  • Phone: 310-553-0100
  • Fax: 424-288-4893

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225XL0004X
TaxonomyLow Vision Occupational Therapist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code152WL0500X
TaxonomyLow Vision Rehabilitation Optometrist
License Number
License Number State

VIII. Authorized Official

Name: FRANCES G LOEW
Title or Position: PRESIDENT
Credential:
Phone: 310-472-4782