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Organization
LADERA MEDICAL PRACTICE INC
Active
Organization
LADERA MEDICAL PRACTICE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEEDEE WESTON (DIRECTOR)
(323) 545-9288
Entity
Organization
Contact information
Practice address
5141 CRENSHAW BLVD, LOS ANGELES, CA 90043-1853
(323) 545-9288
(323) 545-9287
Mailing address
5141 CRENSHAW BLVD, LOS ANGELES, CA 90043-1853
(323) 545-9288
(323) 545-9287
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
CA
2086S0127X
Trauma Surgery Physician
—
CA
208D00000X
General Practice Physician
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A630290
—
CA
05
—
00G459770
—
CA
Enumeration date
04/23/2008
Last updated
03/27/2009
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