Healthcare Provider Details
I. General information
NPI: 1154267276
Provider Name (Legal Business Name): TAPESTRY MEDICAL PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
12100 WILSHIRE BLVD FL 8
LOS ANGELES CA
90025-7120
US
IV. Provider business mailing address
99 HAWLEY LN STE 1102
STRATFORD CT
06614-1204
US
V. Phone/Fax
- Phone: 203-666-8145
- Fax: 203-456-9793
- Phone: 203-666-8145
- Fax: 203-456-9793
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DAVID
CHESS
Title or Position: OWNER
Credential:
Phone: 203-666-8145