| Genesis La Transportion Llc | |
|
26201 Ozone Avenue Harbor City CA 90710 | |
| (562) 449-3878 | |
| Not Available |
| Full Name | Genesis La Transportion Llc |
|---|---|
| Speciality | Social Worker |
| Location | 26201 Ozone Avenue, Harbor City, California |
| Authorized Official Name and Position | Mary Ann Roque (OWNER) |
| Authorized Official Contact | 3106580436 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Genesis La Transportion Llc 8605 Santa Monica Blvd # 273305 West Hollywood CA 90069-4109 Ph: (562) 449-3878 | Genesis La Transportion Llc 26201 Ozone Avenue Harbor City CA 90710 Ph: (562) 449-3878 |
| NPI Number | 1376304436 |
|---|---|
| Provider Enumeration Date | 01/17/2024 |
| Last Update Date | 01/17/2024 |
| Certification Date | 01/09/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376304436 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Primary |
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