Healthcare Provider Details

I. General information

NPI: 1245796184
Provider Name (Legal Business Name): MR. STEVE LEONARDO THOMPSON
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/15/2019
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2116 ARLINGTON AVE STE 100
LOS ANGELES CA
90018-1300
US

IV. Provider business mailing address

PO BOX 835
LA MIRADA CA
90637-0835
US

V. Phone/Fax

Practice location:
  • Phone: 323-334-9000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number133250
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: