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General NPI Number Information
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NPI Number | 1992850150
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Entity Type | Organization
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Legal Business Name | HELENA MBA MD INC.
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Dates
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Enumeration Date | 01/25/2007
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Last Update Date | 06/25/2008
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Provider Practice Location Address
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Address Line | 6485 DAY ST SUITE #203
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City | RIVERSIDE
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State | CA
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Zip | 92507-0929
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Country | US
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Telephone | 951-697-5800
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Fax | 951-697-5801
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Provider Business Mailing Address
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Address Line | 655 S FLOWER ST SUITE #334
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City | LOS ANGELES
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State | CA
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Zip | 90017-2805
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Country | US
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Telephone | 310-462-0181
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Fax | 213-892-2216
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Authorized Official
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Title or Position | DIRECTOR
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Name | HELENA O. MBA
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Credential | MD
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Telephone | 310-462-0181
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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