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General NPI Number Information
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NPI Number | 1588020648
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Entity Type | Organization
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Legal Business Name | ROTACARE OF GREATER LOS ANGELES
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Dates
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Enumeration Date | 01/05/2016
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Last Update Date | 01/05/2016
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Provider Practice Location Address
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Address Line | 6355 TOPANGA CANYON BLVD SUITE 428
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City | WOODLAND HILLS
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State | CA
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Zip | 91367-2102
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Country | US
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Telephone | 877-829-5500
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Fax |
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Provider Business Mailing Address
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Address Line | 6355 TOPANGA CANYON BLVD SUITE 428
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City | WOODLAND HILLS
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State | CA
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Zip | 91367-2102
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Country | US
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Telephone | 877-829-5500
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Fax |
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Authorized Official
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Title or Position | BOARD MEMBER
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Name | MINA MORTEZAI
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Credential | D.O.
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Telephone | 818-592-0055
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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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