VENICE CULVER MARINA MEDICAL GROUP INC – NPI #1376711440
Clinic/Center

VENICE CULVER MARINA MEDICAL GROUP INC is an AHC clinic located in LOS ANGELES, CA. NPPES has assigned the NPI number 1376711440 to VENICE CULVER MARINA MEDICAL GROUP INC on February 12, 2008. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QM1300X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Multi-Specialty

The NPI profile was previously updated about 9 years ago on Oct 10, 2017. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for VENICE CULVER MARINA MEDICAL GROUP INC below.

NPI Profile for
VENICE CULVER MARINA MEDICAL GROUP INC

NPI Number
1376711440
Enumeration Date

(more than 18 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
VENICE CULVER MARINA MEDICAL GROUP INC
Primary location
12212 W WASHINGTON BLVD
LOS ANGELES, CA 90066
Phone: (310) 391-5241 Fax: (310) 397-4324
Mailing address
PO BOX 24706
LOS ANGELES, CA 90024
Phone: (310) 391-5241 Fax: (310) 397-4324
Organization Subpart
Yes - VENICE CULVER MARINA MEDICAL GROUP INC is subpart of another organization.
Authorized Official
JAY TEHRANI
BILLING MANAGER
Phone: (310) 672-9000
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QM1300X
- Clinic/Center / Multi-Specialty (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.