Healthcare Provider Details

I. General information

NPI: 1124567334
Provider Name (Legal Business Name): PMNP MEDICAL SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2017
Last Update Date: 02/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

433 S LAKE ST APT 214
LOS ANGELES CA
90057-2740
US

IV. Provider business mailing address

433 S LAKE ST APT 214
LOS ANGELES CA
90057-2740
US

V. Phone/Fax

Practice location:
  • Phone: 323-423-2040
  • Fax:
Mailing address:
  • Phone: 323-423-2040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. PEDRO ESTRADA MORANTE
Title or Position: CEO
Credential: NP
Phone: 323-423-2040