Organization Active NPI

Quality of Life Medicine PC

  • Rehabilitation Clinic/Center
  • Los Angeles, CA
National Provider Identifier
1437965381
Registry record updated Dec 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
QUALITY OF LIFE MEDICINE PC
Practice address
11400 W Olympic Blvd Ste 200
Los Angeles, CA 90064
Phone
(609) 933-1270
NPI assigned
Dec 5, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2024

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

Authorized official

Name
Dr. Alicia Roldan, DONPI 1891303871
Title
President
Phone
(609) 933-1270

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X Primary

Addresses

Primary practice location

11400 W Olympic Blvd Ste 200
Los Angeles, CA 90064

Mailing address

1501 Lincoln Blvd # 1232
Venice, CA 90291-3503
Phone (609) 933-1270

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1733356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733356800000",
    "number": "1437965381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 LINCOLN BLVD # 1232",
            "city": "VENICE",
            "state": "CA",
            "postal_code": "902913503",
            "telephone_number": "609-933-1270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11400 W OLYMPIC BLVD STE 200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90064",
            "telephone_number": "609-933-1270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUALITY OF LIFE MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-05",
        "last_updated": "2024-12-05",
        "certification_date": "2024-11-13",
        "status": "A",
        "authorized_official_last_name": "ROLDAN",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "609-933-1270",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2024; 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.