Healthcare Provider Details

I. General information

NPI: 1164130068
Provider Name (Legal Business Name): HEALTHY LIFE MEDICAL CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2022
Last Update Date: 11/09/2022
Certification Date: 11/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7537 LAUREL CANYON BLVD UNIT B
NORTH HOLLYWOOD CA
91605-3149
US

IV. Provider business mailing address

7537 LAUREL CANYON BLVD UNIT B
NORTH HOLLYWOOD CA
91605-3149
US

V. Phone/Fax

Practice location:
  • Phone: 818-796-5551
  • Fax: 818-747-2366
Mailing address:
  • Phone: 818-796-5551
  • Fax: 818-747-2366

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL LEPERA
Title or Position: MEDICAL DIRECTOR/ CEO
Credential: MD
Phone: 973-418-4887