Healthcare Provider Details

I. General information

NPI: 1962228874
Provider Name (Legal Business Name): HEALTHCHECK SYSTEMS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/25/2024
Last Update Date: 12/04/2024
Certification Date: 12/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3415 S SEPULVEDA BLVD STE 1250
LOS ANGELES CA
90034-6292
US

IV. Provider business mailing address

841 S CLOVERDALE AVE
LOS ANGELES CA
90036-4818
US

V. Phone/Fax

Practice location:
  • Phone: 917-373-9448
  • Fax: 323-332-0982
Mailing address:
  • Phone: 917-373-9448
  • Fax: 323-332-0982

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KEN MAYER
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 917-373-9448