Cantrell, Mira
Cantrell, Mira is an individual health care provider with primary practice located at 11500 Nimitz Ave , Los Angeles CA 90049-3566. She recently has only one registered license in Allopathic & Osteopathic Physicians / Geriatric Medicine, which is considered as her primary health care specialty. Cantrell, Mira can be contacted via phone (424) 832-8268.Contact Information
Primary practice address
11500 Nimitz Ave
Los Angeles CA 90049-3566
Phone: (424) 832-8268
Fax: (424) 832-8270
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Geriatric Medicine | 207RG0300X | A39040 | California |
Profile Details
| NPI number | 1932147055 |
|---|---|
| LBN Legal business name | Cantrell, Mira |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 2nd, 2006 |
| Last updated | Oct 25th, 2011 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1932147055 | NPPES |
| California | Other | A39040 | LICENCE |
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