Healthcare Provider Details

I. General information

NPI: 1518099142
Provider Name (Legal Business Name): HEALTH EVALUATION CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2007
Last Update Date: 10/16/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2220 W MANCHESTER BLVD
INGLEWOOD CA
90305-2514
US

IV. Provider business mailing address

2220 W MANCHESTER BLVD
INGLEWOOD CA
90305-2514
US

V. Phone/Fax

Practice location:
  • Phone: 323-750-0640
  • Fax: 323-777-6446
Mailing address:
  • Phone: 323-750-0640
  • Fax: 323-777-6446

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License NumberFNP-3233
License Number StateCA

VIII. Authorized Official

Name: MS. IREY DOLORES HILSMAN
Title or Position: ADMINISTRATOR
Credential:
Phone: 323-750-0640