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General NPI Number Information
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NPI Number | 1376199158
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Entity Type | Organization
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Legal Business Name | STEM CELL THERAPEUTICS LA LLC
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Dates
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Enumeration Date | 08/16/2019
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Last Update Date | 08/16/2019
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Provider Practice Location Address
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Address Line | 435 ARDEN AVE STE 420
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City | GLENDALE
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State | CA
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Zip | 91203-4021
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Country | US
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Telephone | 818-294-2657
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Fax | 661-310-3840
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Provider Business Mailing Address
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Address Line | 7319 HANNON ST
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City | DOWNEY
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State | CA
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Zip | 90240-2023
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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 | ADMINISTRATOR
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Name | GINGER JOHNSON
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Credential |
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Telephone | 818-294-2657
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QI0500X
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Taxonomy Name | Infusion Therapy Clinic/Center
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License Number |
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License Number State |
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