Organization
MIRACLE MILE MEDICAL CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES K. THEIRING (CHIEF FINANCIAL OFFICER)
(323) 556-3942
Entity
Organization
Contact information
Practice address
6000 SAN VICENTE BLVD, LOS ANGELES, CA 90036-4404
(323) 930-1040
(323) 937-0525
Mailing address
PO BOX 17358, ENCINO, CA 91416-7358
(323) 930-1040
(323) 937-0525
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
930000143
CA
Other
Enumeration date
01/09/2007
Last updated
06/30/2008
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