Organization
LAX PHYSICAL MEDICINE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHELLEY MCDONALD MD (PRESIDENT)
(310) 670-9999
Entity
Organization
Contact information
Practice address
9100 S SEPULVEDA BLVD, SUITE 104, LOS ANGELES, CA 90045-4849
(310) 670-9999
(310) 670-9994
Mailing address
9100 S SEPULVEDA BLVD, SUITE 104, LOS ANGELES, CA 90045-4849
(310) 670-9999
(310) 670-9994
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
A101415
CA
Other
Enumeration date
06/28/2013
Last updated
08/02/2013
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