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General NPI Number Information
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NPI Number | 1255984910
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Entity Type | Organization
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Legal Business Name | NEO MEDICAL CENTRE
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Dates
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Enumeration Date | 07/22/2019
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Last Update Date | 09/21/2019
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Provider Practice Location Address
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Address Line | 1403 LOMITA BLVD STE 307
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City | HARBOR CITY
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State | CA
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Zip | 90710-2085
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Country | US
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Telephone | 310-456-4317
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Fax |
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Provider Business Mailing Address
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Address Line | 1403 LOMITA BLVD STE 307
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City | HARBOR CITY
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State | CA
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Zip | 90710-2085
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Country | US
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Telephone | 310-456-4317
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | RICHARD KEECH
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Credential | MD
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Telephone | 424-352-0326
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0050X
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Taxonomy Name | Non-Surgical Family Planning Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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