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General NPI Number Information
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NPI Number | 1730844986
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Entity Type | Organization
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Legal Business Name | 2901 ENTERPRISES, LLC
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Dates
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Enumeration Date | 11/03/2021
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Last Update Date | 11/03/2021
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Provider Practice Location Address
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Address Line | 955 N VIGNES ST
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City | LOS ANGELES
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State | CA
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Zip | 90012-2927
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Country | US
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Telephone | 213-215-9238
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Fax | 213-625-0079
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Provider Business Mailing Address
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Address Line | 2272 COLORADO BLVD # 1228
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City | LOS ANGELES
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State | CA
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Zip | 90041-1143
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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 | OWNER
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Name | DAVID AMKRAUT
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Credential | JD
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Telephone | 818-209-4022
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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