LOS ANGELES COUNTY - MAR VISTA MTU NPI 1558416057

NPI Information

NPI: 1558416057
Provider Name: LOS ANGELES COUNTY - MAR VISTA MTU
Classification: Clinic/Center - 261QR0400X
Entity Type: Organization

Specialization: Rehabilitation

Address:
3960 S CENTINELA AVE
LOS ANGELES, CA
ZIP 90066
Phone: (310) 397-0718
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LOS ANGELES COUNTY - MAR VISTA MTU is a rehabilitation clinic center in Los Angeles, CA. LOS ANGELES COUNTY - MAR VISTA MTU NPI is 1558416057. The provider is registered as an organization entity type.

The provider's business location address is:

3960 S CENTINELA AVE
LOS ANGELES, CA
ZIP 90066-905
Phone: (310) 397-0718

The provider's authorized official is Shavonda Webber-christmas .
The authorized official title is Acting Director, Cms and has the following contact phone number (626) 569-6001.

The enumeration date for this NPI number is 1/24/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR0400X	Clinic/Center	Rehabilitation			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	CCS00028F	MEDICAID	CALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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