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NPI Code Detail

MEDICARE: CHRISTOPHER MINNICK

MEDICARE: CHRISTOPHER MINNICK
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
11041C0700XClinical Social WorkerLCS25261CA

General Provider Information

NPI Number : 1841316866
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTOPHER MINNICK
Provider Business Mailing Address
First Line : 470 E 3RD ST STE C
Second Line :
City : LOS ANGELES
State : CA
Zip : 90013-1630
Country : US
Telephone Number : 213-620-5712
Fax Number : 213-621-4155
Provider Business Practice Location Address
First Line : 470 E 3RD ST STE C
Second Line :
City : LOS ANGELES
State : CA
Zip : 90013-1630
Country : US
Telephone Number : 213-620-5712
Fax Number : 213-621-4155
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/21/2007
Last Update Date : 06/18/2014

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Directions to “ CHRISTOPHER MINNICK ” Practice Location

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