Healthcare Provider Details

I. General information

NPI: 1114774262
Provider Name (Legal Business Name): INTEGRATED HEALTH CARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2024
Last Update Date: 05/06/2024
Certification Date: 05/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3535 TORRANCE BLVD STE 13
TORRANCE CA
90503-4815
US

IV. Provider business mailing address

3535 TORRANCE BLVD STE 13
TORRANCE CA
90503-4815
US

V. Phone/Fax

Practice location:
  • Phone: 310-817-5581
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MRS. ANULIKA CHILAKA
Title or Position: FAMILY NURSE PRACTITIONER
Credential:
Phone: 310-686-2347