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General NPI Number Information
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NPI Number | 1588932677
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Entity Type | Organization
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Legal Business Name | TAWC, INC.
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Dates
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Enumeration Date | 12/05/2011
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Last Update Date | 12/05/2011
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Provider Practice Location Address
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Address Line | 8631 W 3RD ST SUITE 1125E
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City | LOS ANGELES
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State | CA
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Zip | 90048-5901
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Country | US
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Telephone | 310-277-7189
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Fax |
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Provider Business Mailing Address
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Address Line | 8631 W 3RD ST SUITE 1125E
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City | LOS ANGELES
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State | CA
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Zip | 90048-5901
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Country | US
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Telephone | 310-277-7189
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN BARRETT
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Credential | D.A.
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Telephone | 310-277-7189
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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 | AC8224
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License Number State | CA
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