Provider Demographics
NPI:1669018826
Name:MLA HEALTH SERVICES INC
Entity Type:Organization
Organization Name:MLA HEALTH SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MAY
Authorized Official - Middle Name:
Authorized Official - Last Name:AGUILAR
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:424-558-2585
Mailing Address - Street 1:20703 IBEX AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90715-1533
Mailing Address - Country:US
Mailing Address - Phone:424-558-2585
Mailing Address - Fax:562-278-2084
Practice Address - Street 1:710 N EUCLID ST
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-4122
Practice Address - Country:US
Practice Address - Phone:424-558-2585
Practice Address - Fax:562-278-2084
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-22
Last Update Date:2019-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty