Healthcare Provider Details

I. General information

NPI: 1437614591
Provider Name (Legal Business Name): OCCUPATIONAL HEALTH CENTERS OF CALIFORNIA, A MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/04/2019
Last Update Date: 02/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

434 S SAN VICENTE BLVD
LOS ANGELES CA
90048-4108
US

IV. Provider business mailing address

5080 SPECTRUM DR STE 1200W
ADDISON TX
75001-4624
US

V. Phone/Fax

Practice location:
  • Phone: 310-360-6780
  • Fax: 310-360-6789
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JOHN ANDERSON
Title or Position: VP
Credential:
Phone: 972-364-8000