Provider Demographics
NPI:1942563804
Name:HEALTHCARE MEDICAL MANAGEMENT SERVICES, INC.
Entity Type:Organization
Organization Name:HEALTHCARE MEDICAL MANAGEMENT SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:MARIANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMIKYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-527-4553
Mailing Address - Street 1:1511 N MARIPOSA AVE APT 6
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-6227
Mailing Address - Country:US
Mailing Address - Phone:323-527-4553
Mailing Address - Fax:
Practice Address - Street 1:1511 N MARIPOSA AVE APT 6
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-6227
Practice Address - Country:US
Practice Address - Phone:323-527-4553
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-15
Last Update Date:2012-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0002578762-0001-6302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization