| Desert DX LLC | |
|
712 N Alta Vista Blvd Los Angeles CA 90046-7602 | |
| (213) 999-0896 | |
| Not Available |
| Full Name | Desert DX LLC |
|---|---|
| Speciality | Clinic/center |
| Location | 712 N Alta Vista Blvd, Los Angeles, California |
| Authorized Official Name and Position | Max Mcnally (CEO) |
| Authorized Official Contact | 2139990896 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Desert DX LLC 157 Ocean Park Blvd Santa Monica CA 90405-3525 Ph: (213) 999-0896 | Desert DX LLC 712 N Alta Vista Blvd Los Angeles CA 90046-7602 Ph: (213) 999-0896 |
| NPI Number | 1346830783 |
|---|---|
| Provider Enumeration Date | 01/20/2021 |
| Last Update Date | 01/20/2021 |
| Certification Date | 01/20/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346830783 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | () | Primary |
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