Healthcare Provider Details

I. General information

NPI: 1366324451
Provider Name (Legal Business Name): LRNM MEDICAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2025
Last Update Date: 08/11/2025
Certification Date: 08/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4551 GLENCOE AVE STE 145
MARINA DEL REY CA
90292-6385
US

IV. Provider business mailing address

4551 GLENCOE AVE STE 145
MARINA DEL REY CA
90292-6385
US

V. Phone/Fax

Practice location:
  • Phone: 310-405-0595
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2081P0301X
TaxonomyBrain Injury Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. NATASHA MEHTA
Title or Position: CFO, SECRETARY
Credential: MD
Phone: 937-238-6561