Organization
GENSTAR CLINICAL II INC
Active
Organization
GENSTAR CLINICAL II INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA MCMAHON (PROGRAM DIRECTOR)
(619) 871-7345
Entity
Organization
Contact information
Practice address
5225 WILSHIRE BLVD STE 1111, LOS ANGELES, CA 90036-4355
(310) 633-3310
Mailing address
5225 WILSHIRE BLVD STE 1111, LOS ANGELES, CA 90036-4355
(310) 633-3310
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
261QE0800X
Endoscopy Clinic/Center
—
—
261QM2500X
Medical Specialty Clinic/Center
—
—
Other
Enumeration date
03/06/2023
Last updated
03/06/2023
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