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Organization
H MICHAEL MYNATT M D INC
Active
Organization
H MICHAEL MYNATT M D INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LIANE R DEYOUNG (ADMINISTRATOR)
(323) 660-7575
Entity
Organization
Contact information
Practice address
1300 N VERMONT AVE STE 100, LOS ANGELES, CA 90027-6061
(323) 913-4300
(323) 913-4301
Mailing address
157 S WINDSOR BLVD, LOS ANGELES, CA 90004-3817
(323) 660-7575
(323) 931-1188
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
G28022
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1326100207
INDIVIDUAL NPI
CA
05
—
1326100207
—
CA
Enumeration date
10/25/2007
Last updated
06/23/2020
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