Provider Demographics
NPI:1457653602
Name:HORTON, HENRY A (MD)
Entity Type:Individual
Prefix:DR
First Name:HENRY
Middle Name:A
Last Name:HORTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8640 W 3RD ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-3384
Mailing Address - Country:US
Mailing Address - Phone:310-786-7204
Mailing Address - Fax:310-734-7268
Practice Address - Street 1:8640 W 3RD ST
Practice Address - Street 2:SUITE 300
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-3384
Practice Address - Country:US
Practice Address - Phone:310-786-7204
Practice Address - Fax:310-734-7268
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-20
Last Update Date:2014-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program