MEDICARE: GOLDEN HOUR PEDIATRICS

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	208000000X	Pediatrics Physician

General Provider Information

NPI Number	:	1184408346
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOLDEN HOUR PEDIATRICS

Provider Business Mailing Address
First Line	:	8023 BEVERLY BLVD STE 11215
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90048-4539
Country	:	US
Telephone Number	:	323-238-2280
Fax Number	:	747-205-0838

Provider Business Practice Location Address
First Line	:	8023 BEVERLY BLVD STE 11215
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90048-4539
Country	:	US
Telephone Number	:	323-238-2280
Fax Number	:	747-205-0838

Authorized Official
Title or Position	:	MD/OWNER
Name	:	NNEAMAKA AJALLA PRIEST
Credential	:	MD
Telephone Number	:	323-238-2280

Provider Enumeration Date	:	08/21/2023
Last Update Date	:	08/21/2023

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Directions to “GOLDEN HOUR PEDIATRICS ” Practice Location

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