Healthcare Provider Details

I. General information

NPI: 1972279719
Provider Name (Legal Business Name): NATURAL BIRTH LA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2021
Last Update Date: 08/20/2021
Certification Date: 08/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

453 S SPRING ST STE 523
LOS ANGELES CA
90013-2077
US

IV. Provider business mailing address

610 S MAIN ST # 205
LOS ANGELES CA
90014-2009
US

V. Phone/Fax

Practice location:
  • Phone: 323-536-2998
  • Fax: 855-701-3163
Mailing address:
  • Phone: 323-536-2998
  • Fax: 855-701-3163

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QB0400X
TaxonomyBirthing Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: FAITH FREEMAN
Title or Position: LICENSED MIDWIFE
Credential: LM549
Phone: 323-536-2998