Organization
MEDI-CURE HEALTH SERVICES, INC.
Active
Other names
Village Academy High School
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPHINE C KANNIKE-MARTINS PHD., RD (CEO/EXECUTIVE DIRECTOR)
(323) 295-1136
Entity
Organization
Contact information
Practice address
1444 E HOLT AVE, POMONA, CA 91767-5865
(909) 397-4900
Mailing address
3756 SANTA ROSALIA DR STE 417, LOS ANGELES, CA 90008-3614
(323) 295-1136
(323) 295-1071
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
190636AN
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
190636AN
DRUG MEDICAL
CA
Enumeration date
06/21/2013
Last updated
06/21/2013
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