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General NPI Number Information
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NPI Number | 1225964323
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Entity Type | Organization
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Legal Business Name | THRIVE LA MEDICAL CLINIC
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Dates
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Enumeration Date | 06/18/2026
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Last Update Date | 06/18/2026
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Provider Practice Location Address
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Address Line | 4221 S ALAMEDA ST
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City | VERNON
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State | CA
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Zip | 90058-1601
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Country | US
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Telephone | 213-515-9069
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Fax |
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Provider Business Mailing Address
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Address Line | 4221 S ALAMEDA ST
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City | VERNON
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State | CA
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Zip | 90058-1601
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Country | US
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Telephone | 213-515-9069
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Fax |
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Authorized Official
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Title or Position | CEO/OWNER
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Name | BROWNELL H PAYNE
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Credential | MD
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Telephone | 213-515-9069
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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