Healthcare Provider Details

I. General information

NPI: 1437682770
Provider Name (Legal Business Name): LPM HEALTHCARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2017
Last Update Date: 04/04/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12045 LAKEWOOD BLVD
DOWNEY CA
90242-2635
US

IV. Provider business mailing address

12045 LAKEWOOD BLVD.
DOWNEY CA
90242
US

V. Phone/Fax

Practice location:
  • Phone: 562-923-4417
  • Fax: 562-923-3167
Mailing address:
  • Phone: 562-923-4417
  • Fax: 562-923-3167

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320700000X
TaxonomyPhysical Disabilities Residential Treatment Facility
License Number197607380
License Number StateCA

VIII. Authorized Official

Name: ADAM ZENOU
Title or Position: MANAGER
Credential:
Phone: 310-857-8218