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General NPI Number Information
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NPI Number | 1588286603
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Entity Type | Organization
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Legal Business Name | TRI HEALTH MEDICAL INSTITUTE MANAGEMENT COMPANY LLC
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Dates
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Enumeration Date | 05/12/2020
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Last Update Date | 07/10/2020
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Provider Practice Location Address
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Address Line | 17777 VENTURA BLVD STE 100
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City | ENCINO
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State | CA
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Zip | 91316-3738
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Country | US
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Telephone | 844-366-6898
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Fax | 844-578-6558
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Provider Business Mailing Address
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Address Line | 90 VANTIS DR UNIT 3062
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City | ALISO VIEJO
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State | CA
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Zip | 92656-2516
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Country | US
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Telephone | 949-307-0412
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Fax |
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Authorized Official
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Title or Position | MEDICAL BILLER
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Name | JOUAN CHEN
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Credential |
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Telephone | 949-307-0412
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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