05D2202848 CLIA NUMBER - OUTREACH CARE MEDICAL GROUP

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Laboratory Demographics

CLIA Number: 05D2202848

Facility Name: OUTREACH CARE MEDICAL GROUP

Facility Address:
5520 SANTA MONICA BLVD STE 110
LOS ANGELES, CA
ZIP 90038
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Facility Phone Number: (760) 754-5663

Facility Type: PHYSICIAN OFFICE

Certificate Type: Waiver

NPI Number: 1285976787

Taxonomy: 207QG0300X - Family Medicine
A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital.

CLIA Record

Field Name	Field Value
CLIA Number	05D2202848
LAB Type	PHYSICIAN OFFICE
Facility Name	OUTREACH CARE MEDICAL GROUP
Street	5520 SANTA MONICA BLVD STE 110
City	LOS ANGELES
State	CA
ZIP	90038
Phone	(760) 754-5663

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This page was last updated on: 5/11/2023