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General NPI Number Information
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NPI Number | 1154407799
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Entity Type | Organization
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Legal Business Name | GREATER LOS ANGELES CARDIOLOGY MEDICAL GROUP
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Dates
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Enumeration Date | 10/27/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 201 S ALVARADO SUITE 612
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City | LOS ANGELES
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State | CA
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Zip | 90057
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Country | US
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Telephone | 213-484-7074
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Fax | 213-484-7075
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Provider Business Mailing Address
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Address Line | 201 S ALVARADO SUITE 612
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City | LOS ANGELES
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State | CA
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Zip | 90057
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Country | US
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Telephone | 213-484-3900
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Fax | 213-484-7075
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Authorized Official
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Title or Position | PRESIDENT
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Name | JEFFREY L HENDEL
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Credential | MD
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Telephone | 213-484-3900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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