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NPI Code Detail

MEDICARE: ANA MEDINA ASSOCIATE OF ARTS

MEDICARE: ANA MEDINA ASSOCIATE OF ARTS
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1063552776
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANA MEDINA ASSOCIATE OF ARTS
Provider Business Mailing Address
First Line : 679 S NEW HAMPSHIRE AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90005-1355
Country : US
Telephone Number : 213-639-0233
Fax Number : 213-388-1491
Provider Business Practice Location Address
First Line : 2500 WILSHIRE BLVD STE 500
Second Line :
City : LOS ANGELES
State : CA
Zip : 90057-4310
Country : US
Telephone Number : 213-639-0233
Fax Number : 213-365-2813
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/08/2007
Last Update Date : 03/14/2022

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Directions to “ ANA MEDINA ASSOCIATE OF ARTS” Practice Location

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