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General NPI Number Information
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NPI Number | 1912148347
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Entity Type | Organization
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Legal Business Name | SVC MEDICAL MANAGEMENT, LLC.
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Dates
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Enumeration Date | 03/15/2009
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Last Update Date | 03/15/2009
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Provider Practice Location Address
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Address Line | 1200 S INGLEWOOD AVE STE 210
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City | INGLEWOOD
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State | CA
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Zip | 90301-8123
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Country | US
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Telephone | 562-602-8844
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Fax | 562-602-8844
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Provider Business Mailing Address
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Address Line | 1200 S INGLEWOOD AVE STE 210
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City | INGLEWOOD
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State | CA
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Zip | 90301-8123
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Country | US
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Telephone | 562-602-8844
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Fax | 562-602-8844
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Authorized Official
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Title or Position | PRESIDENT
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Name | IGNACIO VALDOVINOS
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Credential | MD
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Telephone | 562-602-8844
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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