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Organization
MINDFIELD MEDICAL
Active
Organization
MINDFIELD MEDICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD J BATES (SECRETARY)
(310) 658-4008
Entity
Organization
Contact information
Practice address
6330 SAN VICENTE BLVD STE 510, LOS ANGELES, CA 90048-5455
(310) 658-4008
Mailing address
1138 S CRESCENT HEIGHTS BLVD, LOS ANGELES, CA 90035-2635
(310) 658-4008
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
251F00000X
Home Infusion Agency
—
—
Other
Enumeration date
07/11/2023
Last updated
07/11/2023
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