Healthcare Provider Details

I. General information

NPI: 1609504562
Provider Name (Legal Business Name): LOS ANGELES MIDWIVES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2022
Last Update Date: 08/09/2022
Certification Date: 08/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1445 N GARDNER ST
LOS ANGELES CA
90046-4101
US

IV. Provider business mailing address

1445 N GARDNER ST
LOS ANGELES CA
90046-4101
US

V. Phone/Fax

Practice location:
  • Phone: 818-915-0982
  • Fax: 310-872-1533
Mailing address:
  • Phone: 818-915-0982
  • Fax: 310-872-1533

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number
License Number State

VIII. Authorized Official

Name: LILIT BALDJYAN SARKISSIAN
Title or Position: OWNER
Credential: CNM
Phone: 818-915-0982