Provider Demographics
NPI:1215319231
Name:BNEI AKIVA LOS ANGELES
Entity type:Organization
Organization Name:BNEI AKIVA LOS ANGELES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR AND CAMP DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HELEN
Authorized Official - Middle Name:OSTER
Authorized Official - Last Name:CHERNICOFF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:650-833-8874
Mailing Address - Street 1:4646 BROWNDEER LN
Mailing Address - Street 2:
Mailing Address - City:RANCHO PALOS VERDES
Mailing Address - State:CA
Mailing Address - Zip Code:90275-3912
Mailing Address - Country:US
Mailing Address - Phone:650-833-8874
Mailing Address - Fax:
Practice Address - Street 1:9030 W OLYMPIC BLVD
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-3540
Practice Address - Country:US
Practice Address - Phone:310-248-2450
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-25
Last Update Date:2016-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA64291261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care