| Housecall Md Medical Practice Management, Llc | |
|
2051 N Highland Ave Los Angeles CA 90068-1373 | |
| (833) 432-5633 | |
| (833) 265-2088 |
| Full Name | Housecall Md Medical Practice Management, Llc |
|---|---|
| Speciality | General Practice |
| Location | 2051 N Highland Ave, Los Angeles, California |
| Authorized Official Name and Position | Tareva Marshall (ADMINISTRATIVE AND LEGAL EXECUTIVE) |
| Authorized Official Contact | 7577689126 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Housecall Md Medical Practice Management, Llc 1968 S Coast Hwy # 1469 Laguna Beach CA 92651-3681 Ph: (833) 432-5633 | Housecall Md Medical Practice Management, Llc 2051 N Highland Ave Los Angeles CA 90068-1373 Ph: (833) 432-5633 |
| NPI Number | 1073228177 |
|---|---|
| Provider Enumeration Date | 01/23/2023 |
| Last Update Date | 01/23/2023 |
| Medicare PECOS PAC ID | 1153775440 |
|---|---|
| Medicare Enrollment ID | O20230920001269 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073228177 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Ryan Christian Juhl |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992301063 PECOS PAC ID: 1850706417 Enrollment ID: I20210212002307 |
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