DR. MIRA CANTRELL


Address: 11500 Nimitz Ave, Los Angeles, CA 90049-3566
Phone: 4248328268

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207RG0300X Internal Medicine
Specialization: Geriatric Medicine
A39040 CA Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
CA LICENCE A39040 01

Office Location

Street Address 11500 NIMITZ AVE
City LOS ANGELES
State CA
Zip Code 90049-3566

Providers in the same location

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
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Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 207RG0300X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Geriatric Medicine

Taxonomy Definition

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.

Providers in the same taxonomy and city

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
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Competitor

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City LOS ANGELES
Zip Code 90049

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Dataset Information

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.

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