Healthcare Provider Details

I. General information

NPI: 1184408346
Provider Name (Legal Business Name): GOLDEN HOUR PEDIATRICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2023
Last Update Date: 08/21/2023
Certification Date: 08/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8023 BEVERLY BLVD STE 11215
LOS ANGELES CA
90048-4539
US

IV. Provider business mailing address

8023 BEVERLY BLVD STE 11215
LOS ANGELES CA
90048-4539
US

V. Phone/Fax

Practice location:
  • Phone: 323-238-2280
  • Fax: 747-205-0838
Mailing address:
  • Phone: 323-238-2280
  • Fax: 747-205-0838

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: NNEAMAKA AJALLA PRIEST
Title or Position: MD/OWNER
Credential: MD
Phone: 323-238-2280