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General NPI Number Information
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NPI Number | 1518353606
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Entity Type | Organization
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Legal Business Name | MI HOPE, INC.
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Dates
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Enumeration Date | 04/15/2015
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Last Update Date | 04/15/2015
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Provider Practice Location Address
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Address Line | 3965 HALLEY TERRANCE SE
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City | WASHINGTON
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State | DC
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Zip | 20032
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Country | US
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Telephone | 213-864-6307
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Fax |
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Provider Business Mailing Address
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Address Line | 1634 SPRUCE ST
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City | SOUTH PASADENA
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State | CA
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Zip | 91030-4719
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Country | US
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Telephone | 626-616-2868
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Fax |
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Authorized Official
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Title or Position | DIRECTOR/FOUNDER
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Name | DR. WILLIAM JOHN MARTIN
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Credential | MD
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Telephone | 626-616-2868
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number | 587114966 PMA
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License Number State | DC
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