Healthcare Provider Details

I. General information

NPI: 1699128942
Provider Name (Legal Business Name): CAD MEDICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2016
Last Update Date: 08/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5042 WILSHIRE BLVD 23774
LOS ANGELES CA
90036-4305
US

IV. Provider business mailing address

5042 WILSHIRE BLVD 23774
LOS ANGELES CA
90036-4305
US

V. Phone/Fax

Practice location:
  • Phone: 213-375-3737
  • Fax: 213-634-1177
Mailing address:
  • Phone: 213-375-3737
  • Fax: 213-634-1177

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. CHAD STEVEN NEISWONGER
Title or Position: PARTNER
Credential:
Phone: 213-797-5511