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General NPI Number Information
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NPI Number | 1497258263
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Entity Type | Organization
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Legal Business Name | NEXT DOOR MED NET INC.
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Dates
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Enumeration Date | 03/17/2018
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 5832 S VERMONT AVE
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City | LOS ANGELES
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State | CA
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Zip | 90044-3712
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Country | US
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Telephone | 323-750-7354
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Fax | 323-750-7446
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Provider Business Mailing Address
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Address Line | 5832 S VERMONT AVE
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City | LOS ANGELES
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State | CA
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Zip | 90044-3712
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Country | US
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Telephone | 323-750-7354
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Fax | 323-750-7446
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | NICHOLAS A ROGERS
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Credential | MD
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Telephone | 323-750-7354
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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