Provider Demographics
NPI:1801086616
Name:THE OSTEOPOROSIS MEDICAL CENTER
Entity type:Organization
Organization Name:THE OSTEOPOROSIS MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNT MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:LETHA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-755-8026
Mailing Address - Street 1:8641 WILSHIRE BLVD STE 301
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-2921
Mailing Address - Country:US
Mailing Address - Phone:323-755-8026
Mailing Address - Fax:
Practice Address - Street 1:8641 WILSHIRE BLVD STE 301
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-2921
Practice Address - Country:US
Practice Address - Phone:323-755-8026
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-27
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471B0102XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistBone DensitometryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW10141Medicare PIN