MEDICARE: ME THREE HEALTH SERVICES, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1063250058
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ME THREE HEALTH SERVICES, INC

Provider Business Mailing Address
First Line	:	12100 WILSHIRE BLVD STE 800
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-7140
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	937 3RD ST APT 208
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90403-2516
Country	:	US
Telephone Number	:	818-359-1203
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MS. MICHAL HENDRY
Credential	:	NP
Telephone Number	:	818-359-1203

Provider Enumeration Date	:	07/16/2024
Last Update Date	:	07/16/2024

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