Men Building Men Youth Foundation

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

License

190590BN Issued in CA

Legal business name

MEN BUILDING MEN YOUTH FOUNDATION

Doing business as

Peak Performance Outpatient Services

Practice address

10813 Crenshaw Blvd
Inglewood, CA 90303-2007

Phone

(323) 447-7609

NPI assigned

Jun 9, 2008

Last updated

Jun 9, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kenneth Richard

Title

Companys President

Phone

(323) 447-7609

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Peak Performance Outpatient Services Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1212969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212969600000",
    "number": "1437318995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10813 CRENSHAW BLVD",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903032007",
            "telephone_number": "323-447-7609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10813 CRENSHAW BLVD",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903032007",
            "telephone_number": "323-447-7609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEN BUILDING MEN YOUTH FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-09",
        "last_updated": "2008-06-09",
        "status": "A",
        "authorized_official_last_name": "RICHARD",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "COMPANYS PRESIDENT",
        "authorized_official_telephone_number": "323-447-7609"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "CA",
            "license": "190590BN",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL",
            "identifier": "190590BN",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Peak Performance Outpatient Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• John Patrick Melchor
• Juan Melendez, PHARMD
• Victoria Melendez
• Horace Milano Mellon, M.D.
• Jay Terrell Melton, MD
• Helene Margarite Mendez, AGACNP-BC
• Mercedes C. Mendoza Rodriguez
• Frank Mendoza
• Jose R Mendoza
• Mens Health Foundation 2700

• Early Intervention Provider Agency in Inglewood, CA
• Providers in Inglewood, CA by specialty
• Early Intervention Provider Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.