Provider Demographics
NPI:1508622457
Name:OCEANVIEW HEALTHCARE
Entity Type:Organization
Organization Name:OCEANVIEW HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ECM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:SENDEROVICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-623-7168
Mailing Address - Street 1:1500 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:CA
Mailing Address - Zip Code:90291-3622
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1500 MAIN ST
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:CA
Practice Address - Zip Code:90291-3622
Practice Address - Country:US
Practice Address - Phone:310-623-7168
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-27
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty