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General NPI Number Information
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NPI Number | 1700965530
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Entity Type | Organization
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Legal Business Name | ML & ASSOCIATES NEURO CLINIC, INC
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Dates
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Enumeration Date | 11/03/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2202 W. MARTIN LUTHER KING BLVD,
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City | LOS ANGELES
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State | CA
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Zip | 90008
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Country | US
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Telephone | 323-299-6864
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Fax | 323-299-6884
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Provider Business Mailing Address
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Address Line | P.O.BOX 43246
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City | LOS ANGELES
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State | CA
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Zip | 90043
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Country | US
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Telephone | 323-299-6864
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MELVIN LEWIS
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Credential | MD
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Telephone | 323-299-6864
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | A51248
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License Number State | CA
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