# WEST LA PHYSICAL MEDICINE INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417207614
- **Authorized official:** DR. LARRY HALEM M.D. (MEDICAL DOCTOR)
- **Authorized official phone:** (310) 473-7130

## Contact information

- **Practice address:** 11110 OHIO AVE, SUITE 108, LOS ANGELES, CA 90025-3388
- **Practice address phone:** (310) 473-7130
- **Practice address fax:** (310) 473-5077
- **Mailing address:** 11110 OHIO AVE, SUITE 108, LOS ANGELES, CA 90025-3388
- **Mailing address phone:** (310) 473-7130
- **Mailing address fax:** (310) 473-5077

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | A89000 | CA | Yes |

## Other

- **Enumeration date:** 09/14/2012
- **Last updated:** 08/01/2013