Healthcare Provider Details

I. General information

NPI: 1730844986
Provider Name (Legal Business Name): 2901 ENTERPRISES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2021
Last Update Date: 11/03/2021
Certification Date: 11/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

955 N VIGNES ST
LOS ANGELES CA
90012-2927
US

IV. Provider business mailing address

2272 COLORADO BLVD # 1228
LOS ANGELES CA
90041-1143
US

V. Phone/Fax

Practice location:
  • Phone: 213-215-9238
  • Fax: 213-625-0079
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: DAVID AMKRAUT
Title or Position: OWNER
Credential: JD
Phone: 818-209-4022