Healthcare Provider Details

I. General information

NPI: 1427981273
Provider Name (Legal Business Name): NEA MERE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5520 WILSHIRE BLVD APT 328
LOS ANGELES CA
90036-5778
US

IV. Provider business mailing address

8605 SANTA MONICA BLVD
WEST HOLLYWOOD CA
90069-4109
US

V. Phone/Fax

Practice location:
  • Phone: 323-205-6772
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. GINA MARIE CLAY
Title or Position: OWNER
Credential:
Phone: 323-205-6772