Socalphysicianshousecallcorp
Family Medicine in Los Angeles, CA. Organization (NPI-2).
NPI number1104555366
StatusActive
Last updated in NPPESJul 10, 2022
Details
- NPI
- 1104555366
- Entity type
- Organization (NPI-2)
- Legal business name
- Socalphysicianshousecallcorp
- Organization subpart
- No
- Enumeration date
- Jun 5, 2022
- Certification date
- Jul 10, 2022
- Last updated
- Jul 10, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | – | – | Yes |
Other names
- Socalphysicianshousecall Corp (Other Name)
- Southern California Physicians House Call Corporation (Doing Business As)
Practice location
231 W Vernon Ave Ste 201Los Angeles, CA 90037-2779
Phone 323-828-7929
Mailing address
231 W Vernon Ave Ste 201Los Angeles, CA 90037-2779
Phone 323-828-7929
Authorized official
Barnett John Wesley Grier
Ceo
3238287929
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