Organization
URBAN MED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STACEY NAITO D.O (PHYSICIAN)
(213) 406-8055
Entity
Organization
Contact information
Practice address
408 W 11TH ST, LOS ANGELES, CA 90015-2102
(213) 406-8055
Mailing address
408 W 11TH ST, LOS ANGELES, CA 90015-2102
(213) 406-8055
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
20A8154
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20A8154
LICENSE
CA
Enumeration date
10/05/2011
Last updated
03/07/2023
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