=====================================================
General NPI Number Information
=====================================================
NPI Number | 1598312001
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | US HEALTH CLINICS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/20/2019
-----------------------------------------------------
Last Update Date | 08/08/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 15260 VENTURA BLVD FL 12
-----------------------------------------------------
City | SHERMAN OAKS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91403-5334
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 747-247-2138
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3751 MOTOR AVE STE 1392
-----------------------------------------------------
City | LOS ANGELES
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90034-6403
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 805-625-9245
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGEMENT
-----------------------------------------------------
Name | JOSHUA BAERWALD
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 805-357-5577
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2083P0901X
-----------------------------------------------------
Taxonomy Name | Public Health & General Preventive Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 261QG0250X
-----------------------------------------------------
Taxonomy Name | Genetics Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 261QU0200X
-----------------------------------------------------
Taxonomy Name | Urgent Care Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------