Healthcare Provider Details

I. General information

NPI: 1467744409
Provider Name (Legal Business Name): OFFICE OF ALAN LEVENTHAL P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2011
Last Update Date: 05/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5544 WHITTIER BLVD
COMMERCE CA
90022-4104
US

IV. Provider business mailing address

5544 WHITTIER BLVD
COMMERCE CA
90022-4104
US

V. Phone/Fax

Practice location:
  • Phone: 323-721-4488
  • Fax: 323-721-4788
Mailing address:
  • Phone: 323-721-4488
  • Fax: 323-721-4788

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License NumberSL5153
License Number StateCA

VIII. Authorized Official

Name: MR. BEN LU
Title or Position: MANAGER
Credential:
Phone: 818-957-8942