Organization Name: | QUANTUM HEALING MEDICAL CENTER INC |
NPI Number: | 1043697881 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | FRED GARCIA (PRESIDENT) |
Mailing Address: | 1010 S Robertson Blvd A Los Angeles |
State: | CA US |
Postal Code: | 900351527 |
Phone Number: | 4243020261 |
Fax Number: | 4243020745 |
NPI Enumeration Date: | 04/30/2015 |
NPI Last Update Date: | 04/30/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | A24259 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |