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General NPI Number Information
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NPI Number | 1447496468
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Entity Type | Organization
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Legal Business Name | OLIVE MEDICAL CENTER, INC
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Dates
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Enumeration Date | 12/22/2008
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Last Update Date | 04/28/2014
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Provider Practice Location Address
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Address Line | 740 S OLIVE ST SUITE # 102
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City | LOS ANGELES
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State | CA
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Zip | 90014-2616
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Country | US
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Telephone | 213-627-8018
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Fax | 213-627-0014
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Provider Business Mailing Address
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Address Line | 740 S OLIVE ST SUITE # 102
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City | LOS ANGELES
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State | CA
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Zip | 90014-2616
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Country | US
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Telephone | 213-627-8018
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Fax | 213-627-0014
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOHN SPILLANE BURNS
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Credential | MD
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Telephone | 213-627-8018
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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