# SMILE PEDIATRIC THERAPY AND DIAGNOSTICS

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

## Provider details

- **NPI number:** 1861895401
- **Authorized official:** MADELEINE JAY HAAS M.S., OTR/L (OCCUPATIONAL THERAPIST)
- **Authorized official phone:** (562) 652-1593

## Contact information

- **Practice address:** 5000 W SUNSET BLVD, LOS ANGELES, CA 90027-5861
- **Practice address phone:** (323) 644-9380
- **Mailing address:** 11854 BEVERLY DR, WHITTIER, CA 90601-2737
- **Mailing address phone:** (562) 652-1593

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QX0100X | Occupational Medicine Clinic/Center | 14597 | CA | Yes |

## Other

- **Enumeration date:** 09/26/2014
- **Last updated:** 09/26/2014