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General NPI Number Information
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NPI Number | 1811435431
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Entity Type | Individual
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Provider Name | CAREY E. CAMPBELL CADC-CAS #C7291214
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Gender | Male
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Dates
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Enumeration Date | 02/02/2017
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Last Update Date | 02/02/2017
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Provider Practice Location Address
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Address Line | 360 S WESTLAKE AVE
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City | LOS ANGELES
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State | CA
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Zip | 90057-2906
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Country | US
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Telephone | 213-483-9201
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Fax | 213-382-0136
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Provider Business Mailing Address
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Address Line | 360 S WESTLAKE AVE
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City | LOS ANGELES
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State | CA
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Zip | 90057-2906
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Country | US
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Telephone | 213-483-9201
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Fax | 213-382-0136
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | 190081-JN
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License Number State | CA
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