Organization
MEDIPACE POL
Active
Other names
MEDIPACE MEDICAL GROUP
Organization subpart
No
Provider details
NPI number
Authorized official
MERCEDES BIN (OFFICE MANAGER)
(310) 550-6242
Entity
Organization
Contact information
Practice address
9033 WILSHIRE BLVD, 5TH FLOOR, BEVERLY HILLS, CA 90211-1837
(310) 550-6240
Mailing address
9033 WILSHIRE BLVD, 5TH FLOOR, BEVERLY HILLS, CA 90211-1837
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
CLF4840
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LAB54371F
—
CA
Enumeration date
04/25/2007
Last updated
08/22/2020
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