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General NPI Number Information
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NPI Number | 1548407745
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Entity Type | Organization
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Legal Business Name | OCCUPATIONAL HEALTH CLINIC
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Dates
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Enumeration Date | 01/10/2009
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Last Update Date | 01/10/2009
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Provider Practice Location Address
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Address Line | 7342 W 83RD ST
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City | LOS ANGELES
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State | CA
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Zip | 90045-2452
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Country | US
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Telephone | 310-645-9910
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Fax |
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Provider Business Mailing Address
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Address Line | 7342 W 83RD ST
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City | LOS ANGELES
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State | CA
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Zip | 90045-2452
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Country | US
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Telephone | 310-645-9910
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Fax |
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Authorized Official
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Title or Position | ACUPUNCTURIST
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Name | LISA NELSON
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Credential |
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Telephone | 310-645-9910
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | 11776
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License Number State | CA
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