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General NPI Number Information
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NPI Number | 1821413592
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Entity Type | Organization
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Legal Business Name | LARCHMONT PEDIATRICS, INC.
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Dates
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Enumeration Date | 03/04/2014
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Last Update Date | 03/04/2014
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Provider Practice Location Address
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Address Line | 321 N LARCHMONT BLVD SUITE 1020
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City | LOS ANGELES
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State | CA
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Zip | 90004-3025
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Country | US
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Telephone | 323-960-8500
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Fax | 323-960-8585
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Provider Business Mailing Address
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Address Line | 321 N LARCHMONT BLVD SUITE 1020
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City | LOS ANGELES
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State | CA
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Zip | 90004-3025
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Country | US
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Telephone | 323-960-8500
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Fax | 323-960-8585
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. NEVILLE ANDERSON
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Credential | MD
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Telephone | 323-960-8500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | A91281
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License Number State | CA
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