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1972760213
LONGEVITY MEDICAL CENTER
LOS ANGELES, CA
NPI
1972760213
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Entity Type
Organization
Authorized Contact
HANS D GRUENN
Owner
310-966-9194
Organization Subpart ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: CA A51484)
Enumeration Date
2008-05-22
Last Update Date
2010-12-22
Business Address
LONGEVITY MEDICAL CENTER
2211 CORINTH AVE #204
LOS ANGELES, CA 90064-1650
Phone number: 310-966-9194
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Mailing Address
LONGEVITY MEDICAL CENTER
2211 CORINTH AVE #204
LOS ANGELES, CA 90064-1650
Phone number: 310-966-9194
Copy
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