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General NPI Number Information
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NPI Number | 1073832994
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Entity Type | Organization
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Legal Business Name | HEART CHECK LOS ANGELES LLC
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Dates
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Enumeration Date | 05/18/2010
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Last Update Date | 05/18/2010
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Provider Practice Location Address
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Address Line | 11859 WILSHIRE BLVD STE 110
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City | LOS ANGELES
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State | CA
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Zip | 90025-6600
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Country | US
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Telephone | 310-479-2211
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Fax | 310-479-5563
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Provider Business Mailing Address
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Address Line | 11859 WILSHIRE BLVD STE 110
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City | LOS ANGELES
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State | CA
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Zip | 90025-6600
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Country | US
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Telephone | 310-479-2211
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Fax |
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | CHRIS SHORT
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Credential |
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Telephone | 702-489-6305
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | G87133
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License Number State | CA
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