Organization
PASSPORT HEALTH LOS ANGELES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS RAYANN AZIZ (EXECUTIVE DIRECTOR)
(323) 297-0700
Entity
Organization
Contact information
Practice address
5455 WILSHIRE BLVD, SUITE #1802, LOS ANGELES, CA 90036-4201
(323) 297-0700
(323) 549-9423
Mailing address
5455 WILSHIRE BLVD, SUITE #1802, LOS ANGELES, CA 90036-4201
(323) 297-0700
(323) 549-9423
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
09/09/2009
Last updated
09/09/2009
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