Healthcare Provider Details
I. General information
NPI: 1972925428
Provider Name (Legal Business Name): ENT SENIOR CARE SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/16/2014
Last Update Date: 02/02/2024
Certification Date: 02/02/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9301 WILSHIRE BLVD STE 404
BEVERLY HILLS CA
90210-5424
US
IV. Provider business mailing address
9301 WILSHIRE BLVD STE 404
BEVERLY HILLS CA
90210-5424
US
V. Phone/Fax
- Phone: 310-278-9171
- Fax:
- Phone: 310-278-9171
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM1300X |
| Taxonomy | Multi-Specialty Clinic/Center |
| License Number | |
| License Number State | NULL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 174400000X |
| Taxonomy | Specialist |
| License Number | A21095 |
| License Number State | CA |
VIII. Authorized Official
Name:
HARVEY
D
PALEY
Title or Position: PRESIDENT
Credential: M.D.
Phone: 310-278-9171