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General NPI Number Information
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NPI Number | 1255476180
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Entity Type | Organization
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Legal Business Name | NOEMI CONTRERAS
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Dates
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Enumeration Date | 02/20/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 225 N MARYLAND AVE #D
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City | GLENDALE
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State | CA
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Zip | 91206-4237
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Country | US
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Telephone | 818-242-6424
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 27206
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City | LOS ANGELES
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State | CA
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Zip | 90027-0206
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NOEMI CONTRERAS
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Credential | M.D.
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Telephone | 818-242-6424
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | SW15156A
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License Number State | CA
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