MEDICARE: MEDCHECK HEALTH

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	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1700502119
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDCHECK HEALTH

Provider Business Mailing Address
First Line	:	3831 HUGHES AVE STE 508
Second Line	:
City	:	CULVER CITY
State	:	CA
Zip	:	90232-6855
Country	:	US
Telephone Number	:	310-558-8600
Fax Number	:	310-558-8650

Provider Business Practice Location Address
First Line	:	3831 HUGHES AVE STE 508
Second Line	:
City	:	CULVER CITY
State	:	CA
Zip	:	90232-6855
Country	:	US
Telephone Number	:	310-558-8600
Fax Number	:	310-558-8650

Authorized Official
Title or Position	:	OWNER/CEO
Name	:	LESLIE DIANA PAUL
Credential	:	MD
Telephone Number	:	310-558-8600

Provider Enumeration Date	:	10/17/2022
Last Update Date	:	10/17/2022

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