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General NPI Number Information
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NPI Number | 1487385720
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Entity Type | Organization
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Legal Business Name | POOL OF BETHESDA CHILDREN AND ADULT HOSPITAL
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Dates
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Enumeration Date | 06/17/2022
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Last Update Date | 06/17/2022
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Provider Practice Location Address
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Address Line | 3761 S NORMANDIE AVE
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City | LOS ANGELES
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State | CA
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Zip | 90007-4256
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Country | US
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Telephone | 310-642-8316
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Fax |
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Provider Business Mailing Address
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Address Line | 3761 S NORMANDIE AVE
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City | LOS ANGELES
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State | CA
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Zip | 90007-4256
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Country | US
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Telephone | 310-642-8316
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Fax |
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Authorized Official
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Title or Position | FOUNDER AND CEO
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Name | MS. EMMA VIOLA MONTILINI
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Credential |
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Telephone | 310-642-8316
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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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 | 261QA0005X
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Taxonomy Name | Ambulatory Family Planning Facility
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QR1100X
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Taxonomy Name | Research Clinic/Center
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 281P00000X
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Taxonomy Name | Chronic Disease Hospital
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License Number |
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License Number State |
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