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General NPI Number Information
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NPI Number | 1730331299
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Entity Type | Organization
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Legal Business Name | TOTAL HEALTHCARE
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Dates
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Enumeration Date | 10/16/2008
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Last Update Date | 07/06/2009
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Provider Practice Location Address
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Address Line | 11126 S MAIN ST
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City | LOS ANGELES
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State | CA
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Zip | 90061-1926
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Country | US
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Telephone | 213-779-8398
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Fax | 213-779-8493
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Provider Business Mailing Address
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Address Line | 14482 BEACH BLVD SUITE R
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City | WESTMINSTER
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State | CA
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Zip | 92683-5341
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Country | US
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Telephone | 714-889-7255
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Fax | 714-889-7254
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | EDDIE J SCALES
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Credential | M.D.
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Telephone | 714-889-7255
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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 | G58330
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License Number State | CA
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