Provider Demographics
NPI:1508334871
Name:MEBE LOS ANGELES LLC
Entity Type:Organization
Organization Name:MEBE LOS ANGELES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTRACTS AND CREDENTIALING
Authorized Official - Prefix:MR
Authorized Official - First Name:ESTEBAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-323-0832
Mailing Address - Street 1:8885 RIO SAN DIEGO DR STE 340
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-1669
Mailing Address - Country:US
Mailing Address - Phone:619-795-9925
Mailing Address - Fax:877-602-5087
Practice Address - Street 1:5250 LANKERSHIM BLVD # 507
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91601-3186
Practice Address - Country:US
Practice Address - Phone:619-795-9925
Practice Address - Fax:877-602-5087
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-05
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior AnalystGroup - Multi-Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language AssistantGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty