Organization
HEALTHSMITH MEDICAL INC
Active
Other names
Epiphany360
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANTONIO MARTN OCANA MD (CEO)
(604) 803-8513
Entity
Organization
Contact information
Practice address
9808 VENICE BLVD PH, CULVER CITY, CA 90232-2732
(604) 803-8513
(778) 945-2778
Mailing address
9808 VENICE BLVD PH, CULVER CITY, CA 90232-2732
(604) 803-8513
(778) 945-2778
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
—
—
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
810150870
—
CA
Enumeration date
06/15/2020
Last updated
04/06/2023
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