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TERESA MEDICAL CENTER INC. NPI 1205056033


NPI Information

NPI: 1205056033
Provider Name: TERESA MEDICAL CENTER, INC.
Classification: Obstetrics & Gynecology - 207VG0400X
Entity Type: Organization

Specialization: Gynecology

CLIA Number: 05D1029809

Address:
1407 N VERMONT AVE # A
LOS ANGELES, CA
ZIP 90027
Phone: (310) 908-1007
Get Directions

TERESA MEDICAL CENTER, INC. is a gynecology obstetrics gynecology in Los Angeles, CA. The provider is a physician who specializes in diagnosis, treatment, and management of patients with gynecologic conditions. Source: National Uniform Claim Committee TERESA MEDICAL CENTER, INC. NPI is 1205056033. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1407 N VERMONT AVE # A
LOS ANGELES, CA
ZIP 90027-023
Phone: (310) 908-1007

The provider's authorized official is Arjang Naim .
The authorized official title is Owner and has the following contact phone number (323) 660-5900.

The CLIA number assigned to this NPI record is 05D1029809 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/26/2007 and was last updated on 3/20/2012.


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
1207Q00000XFamily MedicineG15628CALIFORNIANo
2207VX0000XObstetrics & GynecologyObstetricsA70290CALIFORNIANo
3208000000XPediatricsG15628CALIFORNIANo
4207VG0400XObstetrics & GynecologyGynecologyA70290CALIFORNIAYes

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
1W15695MEDICARE ID-TYPE UNSPECIFIEDCALIFORNIAMEDICARE GRP
2GR0090191MEDICAIDCALIFORNIA

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: 5/5/2024

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