Organization
PROMED PROVIDERS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD SHINZATO PORTER (PRESIDENT)
(213) 840-0123
Entity
Organization
Contact information
Practice address
1936 PINEHURST RD, LOS ANGELES, CA 90068-3730
(213) 840-0123
Mailing address
1936 PINEHURST RD, LOS ANGELES, CA 90068-3730
Taxonomy
Speciality
Code
Description
License number
State
364SC2300X
Chronic Care Clinical Nurse Specialist
Primary
—
—
Other
Enumeration date
01/11/2012
Last updated
01/19/2012
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