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General NPI Number Information
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NPI Number | 1447845201
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Entity Type | Organization
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Legal Business Name | OCCUPATIONAL MEDICINE INSTITUTE, DOWNTOWN LOS ANGELES-SOUTH INC.
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Dates
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Enumeration Date | 03/03/2021
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Last Update Date | 08/08/2022
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Provider Practice Location Address
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Address Line | 716 W 1ST ST
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City | LOS ANGELES
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State | CA
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Zip | 90012-2442
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Country | US
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Telephone | 310-405-9292
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Fax |
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Provider Business Mailing Address
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Address Line | 716 W 1ST ST
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City | LOS ANGELES
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State | CA
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Zip | 90012-2442
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Country | US
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Telephone | 310-405-9292
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. KAOCHOY SAECHAO
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Credential | MD
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Telephone | 310-405-9292
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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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Taxonomy #2
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Taxonomy Code | 2083X0100X
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Taxonomy Name | Occupational Medicine Physician
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License Number |
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License Number State |
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