Provider Demographics
NPI:1154589513
Name:L.A. HEALTH SERVICES, INC.
Entity type:Organization
Organization Name:L.A. HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LUMINITA
Authorized Official - Middle Name:
Authorized Official - Last Name:MESESAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-502-9404
Mailing Address - Street 1:126 S JACKSON ST
Mailing Address - Street 2:SUITE 305
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91205-4922
Mailing Address - Country:US
Mailing Address - Phone:818-502-9404
Mailing Address - Fax:818-502-9405
Practice Address - Street 1:126 S JACKSON ST
Practice Address - Street 2:SUITE 305
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91205-4922
Practice Address - Country:US
Practice Address - Phone:818-502-9404
Practice Address - Fax:818-502-9405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-01
Last Update Date:2015-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA980001439251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA059036Medicare Oscar/Certification