Organization
DRH MD MPH A PROFESSIONAL MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DONALD HENDERSON M.D. (PRESIDENT)
(310) 659-8760
Entity
Organization
Contact information
Practice address
8631 W 3RD ST, 1135E, LOS ANGELES, CA 90048-5917
(310) 659-8760
(310) 673-0951
Mailing address
8631 W 3RD ST, 1135E, LOS ANGELES, CA 90048-5901
(310) 659-8760
(310) 673-0951
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
C36510
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00C365100
—
CA
Enumeration date
04/17/2017
Last updated
04/17/2017
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