Provider Demographics
NPI:1962143453
Name:ALL MED SPECIALIST OF LOS ANGELES, INC
Entity type:Organization
Organization Name:ALL MED SPECIALIST OF LOS ANGELES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:DR
Authorized Official - First Name:ERNES
Authorized Official - Middle Name:
Authorized Official - Last Name:BONNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:510-847-1581
Mailing Address - Street 1:PO BOX 2013
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90213-2013
Mailing Address - Country:US
Mailing Address - Phone:213-739-3282
Mailing Address - Fax:
Practice Address - Street 1:11001 MAIN ST STE 301
Practice Address - Street 2:
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91731-2620
Practice Address - Country:US
Practice Address - Phone:626-443-4300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-06
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty