MEDICARE: VAN NESS

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	332B00000X	Durable Medical Equipment & Medical Supplies	0002030788-0001-0	CA

General Provider Information

NPI Number	:	1346275872
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VAN NESS

Provider Business Mailing Address
First Line	:	4369 S VAN NESS AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90062-1454
Country	:	US
Telephone Number	:	323-292-3558
Fax Number	:	323-292-3688

Provider Business Practice Location Address
First Line	:	4369 S VAN NESS AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90062-1454
Country	:	US
Telephone Number	:	323-292-3558
Fax Number	:	323-292-3688

Authorized Official
Title or Position	:	OWNER
Name	:	MS. ROSA DAVITIAN
Credential	:
Telephone Number	:	323-292-3558

Provider Enumeration Date	:	07/12/2006
Last Update Date	:	08/22/2020

Similar Medicare Providers

1619156197 — ROSA DAVITAN
Practice Location Address:

4369 S VAN NESS AVE
LOS ANGELES, CA
90062-1454

Practice Phone: 323-292-3558
Practice Fax: 323-292-3688

1417116773 — VAN NESS HEALTH CARE INC.
Practice Location Address:

4369 S VAN NESS AVE
LOS ANGELES, CA
90062-1454

Practice Phone: 323-292-3558
Practice Fax: 323-292-3688

1891933107 — VAN NESS HEALTHCARE INC
Practice Location Address:

4369 S VAN NESS AVE
LOS ANGELES, CA
90062-1454

Practice Phone: 323-292-3558
Practice Fax: 323-292-3688

1295759199 — BRANDON ADAM GAINES M.S.O.M, LAC
Practice Location Address:

1454 S CREST DR
LOS ANGELES, CA
90035-3312

Practice Phone: 818-961-4046
Practice Fax:

1881794378 — MICHAEL OKONKWO
Practice Location Address:

6109 S WESTERN AVE STE 201
LOS ANGELES, CA
90047-1454

Practice Phone: 323-752-0746
Practice Fax: 323-752-0834

1336240514 — MR. STEWART SUTUT TRITASAVIT M.P.T.
Practice Location Address:

11301 WILSHIRE BLVD , BLDG.500 RM.1454
LOS ANGELES, CA
90073-1003

Practice Phone: 310-478-3711
Practice Fax:

Directions to “VAN NESS ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.