SEPULVEDA PHYSICAL MEDICINE CENTER (NPI# 1164935045) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164935045 |
| Entity Type | Organization |
| Organization Name | SEPULVEDA PHYSICAL MEDICINE CENTER |
| Practice Address |
8632 S Sepulveda Blvd Ste 101 Westchester CA 90045-4013 |
| Practice Telephone | 3103488298 |
| Mailing Telephone | 3103488298 |
| Enumeration Date | 2017-11-14 |
| Last Update Date | 2018-03-17 |
| Authorized Official Name | DARCEY ANN HARRAKA (OWNER) |
| Authorized Official Telephone | 3103488298 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | Allopathic & Osteopathic Physicians | ||
| N | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities | ||
| N | 3336C0002X |
Pharmacy Specialization: Clinic Pharmacy |
Suppliers | ||
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 8632 S Sepulveda Blvd Ste 100, Westchester, CA 900454013 | 3103488298 |
| Street Address |
8632 S SEPULVEDA BLVD STE 101 |
| City | WESTCHESTER |
| State | CA |
| Zip Code | 90045-4013 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396388849 | Laska Dental Inc | Dentist | 5602 W Manchester Ave, Los Angeles, CA 90045 | 2019-10-28 |
| 1245889179 | Ana Arias | Physical Therapist | 6801 Terrace Drive, Suite 200, Los Angeles, CA 90045 | 2019-09-04 |
| 1144719410 | Family Dental Care 4 You | Dentist | 5602 W. Manchester Ave, Los Angeles, CA 90045 | 2018-05-02 |
| 1821504002 | Rhonda Taylor | Counselor | 8703 La Tijera Blvd Ste 201, Los Angeles, CA 90045 | 2017-12-24 |
| 1114436839 | Blanca Melisa Gomez I | Case Manager/Care Coordinator | 7423 1/4 S Sepulveda Blvd, Los Angeles, CA 90045 | 2017-09-26 |
| 1639688831 | Kalila Magbanua-stein | Counselor | 8618 La Tijera Blvd., Suite 200, Los Angeles, CA 90045 | 2017-09-20 |
| 1568984185 | Angela Mull | Marriage & Family Therapist | 8616 Latijera Blvd, Suite 307, Los Angeles, CA 90045 | 2017-07-14 |
| 1386171585 | Patricia Ann Bridewell | Registered Nurse | 5245 Concourse Drive, Suite 100, Los Angeles, CA 90045 | 2017-05-18 |
| 1679937627 | Thelese Consulting Group | Community/Behavioral Health | 8929 S. Sepulveda Blvd, Suite 400, Los Angeles, CA 90045 | 2016-04-06 |
| 1568823318 | Keith Romalis Ellison | Specialist/Technologist | One Lmu Drive, Gersten Pavilion - Athletic Training Room, Los Angeles, CA 90045 | 2016-03-08 |
| Find all providers in zip 90045 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
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| 1982211843 | Crossover Health Medical Group | Clinic/Center | 5379 Hamner Ave Unit 801, Eastvale, CA 91752-1042 | 2020-09-24 |
| 1164039020 | Crossover Health Medical Group | Clinic/Center | 14329 Frederick St Ste 7-9, Moreno Valley, CA 92553-9003 | 2020-09-24 |
| 1104432673 | Aleracare Medical Group of California | Clinic/Center | 17777 Ventura Blvd Ste 220, Encino, CA 91316-3748 | 2020-09-21 |
| 1205447687 | Shawn Richard Oneill | Clinic/Center | 5979 Trotters Ln, Alta Loma, CA 91701-2644 | 2020-08-11 |
| 1134738032 | Healthworks Med Group of California A Medical Corporation | Clinic/Center | 2821 Scott Blvd Ste 2126, Santa Clara, CA 95050-2549 | 2020-07-27 |
| 1437767951 | Miro Health | Clinic/Center | 260 King St Unit 1505, San Francisco, CA 94107-6415 | 2020-07-21 |
| 1598383895 | Alacrity Patient Services, Inc. | Clinic/Center | 1002 N Hudson Ave Apt 1, Los Angeles, CA 90038-2595 | 2020-07-13 |
| 1306464979 | Aleracare Medical Group of California | Clinic/Center | 4849 Van Nuys Blvd Ste 220, Sherman Oaks, CA 91403-2155 | 2020-07-10 |
| Find all providers with the same taxonomy | ||||
| City | WESTCHESTER |
| Zip Code | 90045 |
Please comment or provide details below to improve the information on SEPULVEDA PHYSICAL MEDICINE CENTER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.