Organization
BETH MEDICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMMANUEL A AYODELE MD (MEDICAL DOCTOR)
(323) 779-8398
Entity
Organization
Contact information
Practice address
11126 S MAIN ST, LOS ANGELES, CA 90061-1926
(323) 779-8398
(323) 779-8493
Mailing address
11126 S MAIN ST, LOS ANGELES, CA 90061-1926
(323) 779-8398
(323) 779-8493
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
A46478
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A464780
—
CA
Enumeration date
12/04/2006
Last updated
08/22/2020
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