LONGEVITY MEDICAL CENTER NPI 1972760213

NPI Information

LONGEVITY MEDICAL CENTER is a family medicine in Los Angeles, CA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. LONGEVITY MEDICAL CENTER NPI is 1972760213. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

2211 CORINTH AVE
#204
LOS ANGELES, CA
ZIP 90064-650
Phone: (310) 966-9194
Fax: (310) 966-9196

The provider's authorized official is Hans D Gruenn .
The authorized official title is Owner and has the following contact phone number (310) 966-9194.

The CLIA number assigned to this NPI record is 05D2221991 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/22/2008 and was last updated on 12/22/2010.

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:

Other Identifiers

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