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Organization
KETAMINE CLINICS LLC
Active
Organization
KETAMINE CLINICS LLC
Active
Other names
Ketamine Clinics of Los Angeles
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL HERBERT MANDEL (CHIEF OPERATING OFFICER)
(310) 270-0625
Entity
Organization
Contact information
Practice address
6801 PARK TER STE 525, LOS ANGELES, CA 90045-1543
(310) 270-0625
Mailing address
6801 PARK TER STE 525, LOS ANGELES, CA 90045-1543
(310) 270-0625
(310) 730-5993
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
NULL
Other
Enumeration date
01/08/2019
Last updated
01/08/2019
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