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General NPI Number Information
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NPI Number | 1417249012
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Entity Type | Organization
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Legal Business Name | CARCHI MEDICAL CORPORATION
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Dates
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Enumeration Date | 05/14/2011
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Last Update Date | 05/23/2014
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Provider Practice Location Address
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Address Line | 555 E HARDY ST
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City | INGLEWOOD
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State | CA
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Zip | 90301-4011
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Country | US
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Telephone | 310-680-8195
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Fax | 310-673-0400
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Provider Business Mailing Address
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Address Line | 14001 PALAWAN WAY APT 302
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City | MARINA DEL REY
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State | CA
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Zip | 90292-6201
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Country | US
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Telephone | 310-827-3239
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Fax | 310-827-3239
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | DR. ANNA CARCHI
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Credential | DNP, ACNP
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Telephone | 310-827-3239
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 20168
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License Number State | CA
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