Provider Demographics
NPI:1992131346
Name:HENRY A HORTON MD INC
Entity type:Organization
Organization Name:HENRY A HORTON MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:A
Authorized Official - Last Name:HORTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-786-7204
Mailing Address - Street 1:310 SOUTH HAMEL ROAD
Mailing Address - Street 2:APT 211
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-3883
Mailing Address - Country:US
Mailing Address - Phone:310-786-7204
Mailing Address - Fax:310-734-7268
Practice Address - Street 1:8640 W 3RD STREET
Practice Address - Street 2:SUITE 300
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-3386
Practice Address - Country:US
Practice Address - Phone:310-786-7204
Practice Address - Fax:310-734-7268
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-17
Last Update Date:2013-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty