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General NPI Number Information
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NPI Number | 1386942977
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Entity Type | Organization
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Legal Business Name | BMC MEDICAL INC
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Dates
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Enumeration Date | 03/04/2011
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Last Update Date | 11/09/2011
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Provider Practice Location Address
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Address Line | 11126 S MAIN ST
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City | LOS ANGELES
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State | CA
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Zip | 90061-1926
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Country | US
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Telephone | 323-779-8398
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Fax |
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Provider Business Mailing Address
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Address Line | 11126 S MAIN ST
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City | LOS ANGELES
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State | CA
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Zip | 90061-1926
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Country | US
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Telephone | 323-779-8398
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | EMMANUEL AYODELE
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Credential | MD
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Telephone | 323-779-8398
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | A46478
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License Number State | CA
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