Healthcare Provider Details

I. General information

NPI: 1205531225
Provider Name (Legal Business Name): CITY MEDICAL CENTER INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2023
Last Update Date: 03/31/2023
Certification Date: 03/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 WILSHIRE BLVD STE 510
LOS ANGELES CA
90017-3863
US

IV. Provider business mailing address

700 WILSHIRE BLVD STE 510
LOS ANGELES CA
90017-3863
US

V. Phone/Fax

Practice location:
  • Phone: 213-415-1990
  • Fax: 213-415-1940
Mailing address:
  • Phone: 213-415-1990
  • Fax: 213-415-1940

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. CHAD HENG
Title or Position: OWNER
Credential: MD
Phone: 626-297-5379