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General NPI Number Information
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NPI Number | 1346681376
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Entity Type | Organization
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Legal Business Name | DEANCO HEALTHCARE, LLC
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Dates
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Enumeration Date | 07/06/2013
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Last Update Date | 07/06/2013
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Provider Practice Location Address
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Address Line | 14850 ROSCOE BLVD
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City | PANORAMA CITY
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State | CA
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Zip | 91402-4618
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Country | US
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Telephone | 818-904-3685
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Fax |
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Provider Business Mailing Address
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Address Line | 8447 WILSHIRE BLVD SUITE 202
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City | BEVERLY HILLS
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State | CA
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Zip | 90211-3226
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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 | CHAIRMAN
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Name | DAVID HERMAN
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Credential |
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Telephone | 310-854-7773
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number |
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License Number State |
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