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NPI Code Detail

MEDICARE: COMMUNITY WEST LLC

MEDICARE: COMMUNITY WEST LLC
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
1261QM0850XAdult Mental Health Clinic/Center
2261QM0855XAdolescent and Children Mental Health Clinic/Center

General Provider Information

NPI Number : 1679060669
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMMUNITY WEST LLC
Provider Business Mailing Address
First Line : 1990 S BUNDY DR STE 320
Second Line :
City : LOS ANGELES
State : CA
Zip : 90025-5249
Country : US
Telephone Number : 310-990-0988
Fax Number :
Provider Business Practice Location Address
First Line : 1990 S BUNDY DR STE 320
Second Line :
City : LOS ANGELES
State : CA
Zip : 90025-5249
Country : US
Telephone Number : 310-990-0988
Fax Number :
Authorized Official
Title or Position : CO-FOUNDER
Name : MARC SANDERS
Credential : PHD, FIPA
Telephone Number : 310-497-5995
Provider Enumeration Date : 04/16/2018
Last Update Date : 04/16/2018

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Directions to “COMMUNITY WEST LLC ” 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.

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