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General NPI Number Information
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NPI Number | 1629686324
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Entity Type | Organization
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Legal Business Name | INSIGHT PRACTICE PARTNERS MEDICAL GROUP INC
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Dates
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Enumeration Date | 07/20/2020
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Last Update Date | 07/20/2020
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Provider Practice Location Address
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Address Line | 5901 W CENTURY BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90045-5411
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Country | US
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Telephone | 310-714-7877
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 159
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City | MANHATTAN BEACH
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State | CA
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Zip | 90267-0159
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | COO
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Name | MICHELLE MCGEE
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Credential |
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Telephone | 310-923-5523
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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