# LIFE CARE MEDICAL CLINIC A PROFESSIONAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** LIFE CARE MEDICAL CLINIC A PROFESSIONAL CORPORATION
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1962797738
- **Legal business name:** LIFE CARE MEDICAL CLINIC A PROFESSIONAL CORPORATION
- **Authorized official:** JOHN LEONARD GOFF M.D. (PRESIDENT)
- **Authorized official phone:** (323) 664-4044

## Contact information

- **Practice address:** 1211 N VERMONT AVE, SUITE 207, LOS ANGELES, CA 90029-1748
- **Practice address phone:** (323) 664-4044
- **Mailing address:** 1211 N VERMONT AVE, SUITE 207, LOS ANGELES, CA 90029-1748
- **Mailing address phone:** (323) 664-4044

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207P00000X | Emergency Medicine Physician | C30424 | CA | — |
| 208D00000X | General Practice Physician | C30424 | CA | Yes |
| 251E00000X | Home Health Agency | C30424 | CA | — |

## Other

- **Enumeration date:** 06/09/2011
- **Last updated:** 07/15/2011