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General NPI Number Information
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NPI Number | 1265470868
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Entity Type | Organization
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Legal Business Name | IDEAL HEALTH CARE AND MEDICAL
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Dates
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Enumeration Date | 06/04/2006
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Last Update Date | 05/22/2014
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Provider Practice Location Address
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Address Line | 6245 DE LONGPRE AVE 206
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City | HOLLYWOOD
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State | CA
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Zip | 90028-8253
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Country | US
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Telephone | 323-462-2271
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Fax | 323-785-1223
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Provider Business Mailing Address
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Address Line | 6245 DE LONGPRE AVE 206
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City | HOLLYWOOD
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State | CA
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Zip | 90028-8253
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Country | US
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Telephone | 323-462-2271
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Fax | 323-785-1223
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | ARNEL JOAQUIN
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Credential | M.D.
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Telephone | 323-462-2271
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State | CA
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