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General NPI Number Information
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NPI Number | 1972064004
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Entity Type | Organization
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Legal Business Name | DIVINE HELP MEDICAL GROUP INC
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Dates
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Enumeration Date | 03/29/2019
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Last Update Date | 03/29/2019
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Provider Practice Location Address
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Address Line | 1711 W TEMPLE ST UNIT 5613
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City | LOS ANGELES
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State | CA
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Zip | 90026-5421
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Country | US
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Telephone | 213-483-8400
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 426
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City | LAWNDALE
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State | CA
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Zip | 90260-0426
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Country | US
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Telephone | 213-483-8400
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ABDUL KHAN
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Credential | MD
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Telephone | 213-483-8400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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