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General NPI Number Information
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NPI Number | 1669171625
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Entity Type | Organization
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Legal Business Name | HENNESSAY MEDICAL CORPORATION
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Dates
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Enumeration Date | 02/28/2023
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Last Update Date | 03/21/2023
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Provider Practice Location Address
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Address Line | 3655 LOMITA BLVD STE 307
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City | TORRANCE
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State | CA
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Zip | 90505-1922
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Country | US
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Telephone | 424-235-5235
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Fax | 949-404-6987
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Provider Business Mailing Address
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Address Line | 2604 W 225TH ST
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City | TORRANCE
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State | CA
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Zip | 90505-2902
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Country | US
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Telephone | 310-365-8625
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Fax | 424-447-8239
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MEGAN HENNESSAY
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Credential | DO
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Telephone | 424-235-5235
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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