Organization Name: | R. DHANES A MEDICAL CORP |
NPI Number: | 1023131117 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RICHARD P. DHANES (PRESIDENT) |
Mailing Address: | 1240 S Westlake Blvd Ste 113 Westlake Village |
State: | CA US |
Postal Code: | 913611977 |
Phone Number: | 8054954527 |
Fax Number: | |
NPI Enumeration Date: | 04/06/2007 |
NPI Last Update Date: | 09/10/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2300X |
License Number: | G19135 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |