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Organization

RAND SCHRADER 5P21 CLINIC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LANOMAY BENJAMIN RN (NURSE MANAGER)
(323) 343-8255
Entity
Organization

Contact information

Practice address
1300 N MISSION RD, LOS ANGELES, CA 90033-1021
(323) 343-8255
Mailing address
811 S WILTON PL, APT 7, LOS ANGELES, CA 90005-3544

Taxonomy

Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
272539
CA

Other

Enumeration date
08/29/2014
Last updated
08/29/2014
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