Healthcare Provider Details

I. General information

NPI: 1912813627
Provider Name (Legal Business Name): MARY C NASMYTH MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2070 CENTURY PARK E
LOS ANGELES CA
90067-1907
US

IV. Provider business mailing address

137 N LARCHMONT BLVD STE 139
LOS ANGELES CA
90004-3704
US

V. Phone/Fax

Practice location:
  • Phone: 424-522-7100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: MARY NASMYTH
Title or Position: OWNER
Credential: MD
Phone: 424-354-1255