Healthcare Provider Details

I. General information

NPI: 1467698340
Provider Name (Legal Business Name): PRIORITY HEALTH CARE SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/26/2008
Last Update Date: 07/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2023 W COMPTON BLVD
COMPTON CA
90220-1312
US

IV. Provider business mailing address

2023 W COMPTON BLVD
COMPTON CA
90220-1312
US

V. Phone/Fax

Practice location:
  • Phone: 310-461-5290
  • Fax:
Mailing address:
  • Phone: 310-461-5290
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License Number
License Number State

VIII. Authorized Official

Name: MR. VICTOR T ANYAKWO
Title or Position: PROGRAM DIRECTOR
Credential:
Phone: 310-461-5290