Healthcare Provider Details

I. General information

NPI: 1457261240
Provider Name (Legal Business Name): STELLA MIDDLE CHARTER ACADEMY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4301 W MARTIN LUTHER KING JR BLVD
LOS ANGELES CA
90008-1719
US

IV. Provider business mailing address

4301 W MARTIN LUTHER KING JR BLVD
LOS ANGELES CA
90008-1719
US

V. Phone/Fax

Practice location:
  • Phone: 323-406-7155
  • Fax:
Mailing address:
  • Phone: 323-406-7155
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number StateNULL

VIII. Authorized Official

Name: ANA MARTINEZ
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 310-882-8274