DR. MIRA CANTRELL (NPI# 1932147055) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1932147055 |
Entity Type | Individual |
Full Name | DR. MIRA CANTRELL |
Credential | MD |
Practice Address |
11500 Nimitz Ave Los Angeles CA 90049-3566 |
Practice Telephone | 4248328268 |
Practice Fax Number | 4248328270 |
Mailing Telephone | 4248328268 |
Mailing Fax Number | 4248328270 |
Enumeration Date | 2006-06-02 |
Last Update Date | 2011-10-25 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207RG0300X |
Internal Medicine Specialization: Geriatric Medicine |
A39040 | CA | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
CA | LICENCE | A39040 | 01 |
Street Address |
11500 NIMITZ AVE |
City | LOS ANGELES |
State | CA |
Zip Code | 90049-3566 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1306897053 | Robert Elliot Neshkes | Psychiatry & Neurology | 11500 Nimitz Ave, Los Angeles, CA 90049-3566 | 2006-05-15 |
1174149231 | Parastoo Shadmani | Dietitian, Registered | 11500 Nimitz Ave, Los Angeles, CA 90049-3566 | 2020-06-24 |
1689192346 | Suzanne Marie Banda | Speech-Language Pathologist | 11500 Nimitz Ave, Los Angeles, CA 90049-3566 | 2017-09-01 |
1043659931 | Sun Chang | Occupational Therapist | 11500 Nimitz Ave, Los Angeles, CA 90049-3566 | 2013-06-24 |
1932447232 | Priscilla Park | Occupational Therapist | 11500 Nimitz Ave, Los Angeles, CA 90049-3566 | 2013-01-21 |
1639413503 | Robert Stephen Wilkes | Social Worker | 11500 Nimitz Ave, Los Angeles, CA 90049-3566 | 2012-11-16 |
1477826709 | Jennifer C Wu | Pharmacist | 11500 Nimitz Ave, Attn: Pharmacy, Los Angeles, CA 90049-3566 | 2012-02-16 |
1659691178 | Stanley T Nomura | Pharmacist | 11500 Nimitz Ave, Pharmacy Dept, Los Angeles, CA 90049-3566 | 2010-06-07 |
1821316076 | Department of Veterans Affairs of The State of California | Assisted Living Facility | 11500 Nimitz Ave, Los Angeles, CA 90049-3566 | 2010-05-12 |
1093942179 | Kistyn Joi Gritney | Social Worker | 11500 Nimitz Ave, Los Angeles, CA 90049-3566 | 2009-06-16 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1316564339 | Kepp Family & Group Practice | Marriage & Family Therapist | 12011 San Vincente Blvd, 408, Los Angeles, CA 90049 | 2020-06-26 |
1386204493 | Steven J Lehrman | Marriage & Family Therapist | 179 S. Barrington Place, Office A, Los Angeles, CA 90049 | 2019-06-20 |
1922562990 | Jand. Inc. | Eyewear Supplier (Equipment, not the service) | 860 S. Sepulveda Blvd., Los Angeles, CA 90049 | 2019-01-24 |
1851864946 | Christie Schnur | Marriage & Family Therapist | 11911 San Vicente Blvd., Los Angeles, CA 90049 | 2019-01-10 |
1669954012 | Barbara Jiji Schenk | Marriage & Family Therapist | 520 S. Sepulveda Blvd #402, Los Angeles, CA 90049 | 2018-09-02 |
1972090710 | Community Reflections Inc | Counselor | 10020 So. Western Ave, 10020 So. Western Ave, Los Angeles, CA 90049 | 2018-04-17 |
1245738830 | Dr. Shirin Tabib LLC | Marriage & Family Therapist | 61133 San Vincent Blvd, Suite 318 A, Los Angeles, CA 90049 | 2018-01-29 |
1295240679 | Robert A Brooks | Preventive Medicine | 149 South Barrington Ave, #346, Los Angeles, CA 90049 | 2017-12-07 |
1598286478 | Marvin S Serrano | Physical Therapy Assistant | 11740 San Vicente Boulevard Suite 205, Los Angeles, CA 90049 | 2017-06-30 |
1972055812 | Evolve Growth Initiatives, LLC | Psychiatric Residential Treatment Facility | 820 Moraga Drive, Los Angeles, CA 90049 | 2016-10-26 |
Find all providers in zip 90049 |
Taxonomy Code | 207RG0300X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Geriatric Medicine |
An internist who has 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. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1972081412 | Ahra Cho, M.d., Inc | Internal Medicine | 2727 W Olympic Blvd Ste 205, Los Angeles, CA 90006-2640 | 2018-08-06 |
1063714749 | Daniel L. Gornel | Internal Medicine | 1136 Hi Point St, Los Angeles, CA 90035-2610 | 2010-12-01 |
1295932937 | Angela Moore-hodge | Internal Medicine | 2975 Wilshire Blvd Ste 401, 4116 Camino Real Los Angeles, Ca. 90065, Los Angeles, CA 90010-1112 | 2007-06-27 |
1659445823 | Francisco Quijas | Internal Medicine | 1700 Cesar Chavez Ave, Senior Care Clinic, Los Angeles, CA 90033-2414 | 2006-11-20 |
1285741579 | Vinod I Patel | Internal Medicine | 12021 S. Wilmingtom Ave, Los Angeles, CA 90059 | 2006-08-24 |
1265467864 | David Avram Ganz | Internal Medicine | 11301 Wilshire Blvd (11g), Los Angeles, CA 90073-1003 | 2006-07-11 |
1831129063 | La Town Medical Group, Inc. | Internal Medicine | 3663 W 6th St, Suite 206, Los Angeles, CA 90020-3049 | 2006-07-04 |
1174585376 | Zaldy S Tan | Internal Medicine | 127 S San Vicente Blvd # A6600, Los Angeles, CA 90048-3311 | 2006-04-04 |
1891764304 | Sakaye Shigekawa M.d. | Internal Medicine | 1511 N Benton Way, Los Angeles, CA 90026-2218 | 2006-03-16 |
1134109200 | Dong Hyun Lee | Internal Medicine | 2727 W Olympic Blvd Ste 309, Los Angeles, CA 90006-2699 | 2006-01-17 |
Find all providers in LOS ANGELES |
City | LOS ANGELES |
Zip Code | 90049 |
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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.