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General NPI Number Information
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NPI Number | 1700198447
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Entity Type | Organization
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Legal Business Name | EAGLE-1 HEALTHCARE INC
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Dates
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Enumeration Date | 07/10/2010
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Last Update Date | 07/10/2010
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Provider Practice Location Address
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Address Line | 240 N VIRGIL AVE 7
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City | LOS ANGELES
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State | CA
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Zip | 90004-5399
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Country | US
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Telephone | 213-426-0555
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Fax | 213-739-8843
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Provider Business Mailing Address
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Address Line | 240 N VIRGIL AVE 7
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City | LOS ANGELES
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State | CA
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Zip | 90004-5399
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Country | US
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Telephone | 213-426-0555
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Fax | 213-739-8843
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | DR. HOWARD T PFUPAJENA
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Credential | MD
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Telephone | 213-426-0555
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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 | G29345
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License Number State | CA
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