| Lifetree Healthcare Inc | |
|
13750 Victory Blvd Van Nuys CA 91401-2324 | |
| (818) 809-2437 | |
| (818) 809-2427 |
| Full Name | Lifetree Healthcare Inc |
|---|---|
| Speciality | General Practice |
| Location | 13750 Victory Blvd, Van Nuys, California |
| Authorized Official Name and Position | Fernando Tiongson Enrile (PRESIDENT) |
| Authorized Official Contact | 8188092437 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifetree Healthcare Inc 13750 Victory Blvd Van Nuys CA 91401-2324 Ph: (818) 809-2437 | Lifetree Healthcare Inc 13750 Victory Blvd Van Nuys CA 91401-2324 Ph: (818) 809-2437 |
| NPI Number | 1821789603 |
|---|---|
| Provider Enumeration Date | 05/15/2023 |
| Last Update Date | 05/15/2023 |
| Medicare PECOS PAC ID | 7618335910 |
|---|---|
| Medicare Enrollment ID | O20230619001408 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821789603 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Fernando T Enrile |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1073671814 PECOS PAC ID: 2466445861 Enrollment ID: I20040402001490 |
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