Healthcare Provider Details

I. General information

NPI: 1881507390
Provider Name (Legal Business Name): MORGAN BLCK LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5114 WEST BLVD
LOS ANGELES CA
90043-2303
US

IV. Provider business mailing address

5114 WEST BLVD
LOS ANGELES CA
90043-2303
US

V. Phone/Fax

Practice location:
  • Phone: 310-722-1140
  • Fax:
Mailing address:
  • Phone: 424-521-7175
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: JENNENE PUGH
Title or Position: MANAGING MEMBER
Credential: MBA
Phone: 310-722-1140