Myra Consortium

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

MYRA CONSORTIUM

Practice address

7602 Earldom Ave
Playa del Rey, CA 90293-8004

Phone

(213) 840-1161

NPI assigned

Sep 23, 2022

Organization subpart

No

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

Authorized official

Name

Chris Myers

Title

Ceo

Phone

(213) 840-1161

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1663891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663891200000",
    "number": "1437872587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7602 EARLDOM AVE",
            "city": "PLAYA DEL REY",
            "state": "CA",
            "postal_code": "902938004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7602 EARLDOM AVE",
            "city": "PLAYA DEL REY",
            "state": "CA",
            "postal_code": "902938004",
            "telephone_number": "213-840-1161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYRA CONSORTIUM",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-23",
        "last_updated": "2022-09-23",
        "certification_date": "2022-09-23",
        "status": "A",
        "authorized_official_last_name": "MYERS",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "213-840-1161"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamie Miller, MA, PHD
• Mark J Mitchell
• Michael Christopher Montgomery, DDS
• Andrea Moore, LMFT
• La Toya Chante Morris, D.D.S.
• Kailie Nicole Kaleikaumaka Nakamoto, FNP-C
• Kenneth Kenji Nakamura, D.D.S.
• Jennifer Necessary, PHARMD
• Zoulikha Nedjar
• Nidia Hernandez, Licensed Clinical Social Worker, Inc.,

• Clinical Medical Laboratory in Playa del Rey, CA
• Providers in Playa del Rey, CA by specialty
• Clinical Medical Laboratory in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2022; 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.