Healthcare Provider Details
I. General information
NPI: 1902435753
Provider Name (Legal Business Name): READY RESPONDERS CALIFORNIA PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/03/2020
Last Update Date: 05/26/2021
Certification Date: 05/26/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1308 FACTORY PL APT 103
LOS ANGELES CA
90013-2255
US
IV. Provider business mailing address
5065 WOOSTER RD # 005818
CINCINNATI OH
45226-2326
US
V. Phone/Fax
- Phone: 504-370-9966
- Fax:
- Phone: 504-370-9966
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208D00000X |
| Taxonomy | General Practice Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
STEPHANIE
NORIEA
Title or Position: SECRETARY
Credential:
Phone: 512-341-0900