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General NPI Number Information
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NPI Number | 1801248588
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Entity Type | Organization
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Legal Business Name | NEONATAL SPECIALTY CARE MEDICAL CARE, INC.
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Dates
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Enumeration Date | 07/06/2016
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Last Update Date | 07/06/2016
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Provider Practice Location Address
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Address Line | 1401 S GRAND AVE
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City | LOS ANGELES
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State | CA
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Zip | 90015-3010
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Country | US
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Telephone | 213-742-5716
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Fax | 949-366-2390
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Provider Business Mailing Address
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Address Line | 322 CULVER BLVD STE 324
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City | PLAYA DEL REY
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State | CA
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Zip | 90293-7704
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Country | US
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Telephone | 310-508-8858
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Fax | 949-366-2390
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. SCOTT A BEASLEY
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Credential | M.D.
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Telephone | 310-508-8858
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | 546190
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License Number State | CA
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