Healthcare Provider Details

I. General information

NPI: 1487105953
Provider Name (Legal Business Name): MEDICAL LEGAL EXPERTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2016
Last Update Date: 10/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14623 HAWTHORNE BLVD SUITE 406
LAWNDALE CA
90260-1581
US

IV. Provider business mailing address

14623 HAWTHORNE BLVD SUITE 406
LAWNDALE CA
90260-1581
US

V. Phone/Fax

Practice location:
  • Phone: 877-204-5682
  • Fax: 310-356-7910
Mailing address:
  • Phone: 877-204-5682
  • Fax: 310-356-7910

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License Number
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number
License Number StateCA

VIII. Authorized Official

Name: MS. JENNIFER K DUMALO
Title or Position: LIEN RESOLUTION REPRESENTATIVE
Credential: M.A., COMMUNICATIONS
Phone: 310-387-9517