Healthcare Provider Details

I. General information

NPI: 1891899548
Provider Name (Legal Business Name): THE BEST OF TIMES ADUC 2 INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4350 11TH AVE
LA CA
90008
US

IV. Provider business mailing address

PO BOX 351033
LA CA
90035
US

V. Phone/Fax

Practice location:
  • Phone: 323-292-2898
  • Fax: 323-292-2126
Mailing address:
  • Phone: 323-292-2898
  • Fax: 323-292-2126

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARINA BRIK
Title or Position: ADMINISTRATOR
Credential: ADMINISTRATOR
Phone: 323-292-2898