MEDICARE: MAJOR MEDICAL CENTER INC

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	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1952406399
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAJOR MEDICAL CENTER INC

Provider Business Mailing Address
First Line	:	311 N. ROBERTSON BLVD # 373
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90211-1705
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1411 W 54TH ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90062-2806
Country	:	US
Telephone Number	:	323-752-5400
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. OWUSU FIREMPONG
Credential	:	M.D.
Telephone Number	:	323-752-5400

Provider Enumeration Date	:	09/13/2006
Last Update Date	:	08/22/2020

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