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General NPI Number Information
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NPI Number | 1881777860
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Entity Type | Organization
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Legal Business Name | L.A. MEDICAL MANAGEMENT, INC.
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 09/14/2009
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Provider Practice Location Address
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Address Line | 11850 WILSHIRE BLVD SUITE 102
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City | LOS ANGELES
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State | CA
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Zip | 90025-6609
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Country | US
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Telephone | 310-478-8400
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Fax | 310-478-8499
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Provider Business Mailing Address
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Address Line | 11850 WILSHIRE BLVD SUITE 102
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City | LOS ANGELES
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State | CA
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Zip | 90025-6609
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Country | US
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Telephone | 310-478-8400
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Fax | 310-478-8499
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Authorized Official
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Title or Position | PREDIDENT
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Name | MRS. MICHELLE MOORE
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Credential |
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Telephone | 310-478-8400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 550000461
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License Number State | CA
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