| Alfred Lavi, D.o. Professional Corporation | |
|
2324 W Pico Blvd Los Angeles CA 90006-4002 | |
| (310) 210-5880 | |
| (213) 383-5300 |
| Full Name | Alfred Lavi, D.o. Professional Corporation |
|---|---|
| Speciality | Family Medicine |
| Location | 2324 W Pico Blvd, Los Angeles, California |
| Authorized Official Name and Position | Alfred Lavi (OWNER) |
| Authorized Official Contact | 2133833600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alfred Lavi, D.o. Professional Corporation 2324 W Pico Blvd Los Angeles CA 90006-4002 Ph: (213) 383-3600 | Alfred Lavi, D.o. Professional Corporation 2324 W Pico Blvd Los Angeles CA 90006-4002 Ph: (310) 210-5880 |
| NPI Number | 1629198791 |
|---|---|
| Provider Enumeration Date | 03/30/2007 |
| Last Update Date | 12/07/2023 |
| Medicare PECOS PAC ID | 8921063546 |
|---|---|
| Medicare Enrollment ID | O20041123000616 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629198791 | NPI | - | NPPES |
| 00AX76530 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 20A7653 (California) | Primary |
| Provider Name | Alfred Lavi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184739039 PECOS PAC ID: 2466417084 Enrollment ID: I20041124000229 |
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