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General NPI Number Information
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NPI Number | 1437792264
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Entity Type | Organization
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Legal Business Name | AMOS K LADOUCEUR MD INC
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Dates
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Enumeration Date | 10/24/2019
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Last Update Date | 09/22/2023
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Provider Practice Location Address
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Address Line | 3750 SANTA ROSALIA DR UNIT 1
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City | LOS ANGELES
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State | CA
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Zip | 90008-3627
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Country | US
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Telephone | 310-910-7221
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Fax | 310-910-7188
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Provider Business Mailing Address
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Address Line | 5419 HOLLYWOOD BLVD STE 224
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City | LOS ANGELES
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State | CA
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Zip | 90027-3480
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Country | US
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Telephone | 267-648-9308
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Fax |
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Authorized Official
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Title or Position | OWNER/CEO
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Name | DR. AMOS KELLY LADOUCEUR
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Credential | MD
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Telephone | 267-648-9308
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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