Organization
INTERNATIONAL MEDICAL GROUP INC, HOME HEALTHCARE & HOSPICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANTHONY VERA MD (CEO)
(323) 893-6632
Entity
Organization
Contact information
Practice address
14431 VENTURA BLVD STE 507, SHERMAN OAKS, CA 91423-2606
(323) 893-6632
(323) 798-8770
Mailing address
14431 VENTURA BLVD STE 507, SHERMAN OAKS, CA 91423-2606
(323) 893-6632
(323) 798-8770
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
—
—
224Z00000X
Occupational Therapy Assistant
—
—
251E00000X
Home Health Agency
—
—
251G00000X
Community Based Hospice Care Agency
Primary
—
—
251J00000X
Nursing Care Agency
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
315D00000X
Inpatient Hospice
—
—
3336H0001X
Home Infusion Therapy Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A8660
HHA
CA
Enumeration date
08/25/2020
Last updated
08/25/2020
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