Provider Demographics
NPI:1043337504
Name:VEN, BORADY (CASE MANAGER)
Entity type:Individual
Prefix:
First Name:BORADY
Middle Name:
Last Name:VEN
Suffix:
Gender:F
Credentials:CASE MANAGER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 W OLYMPIC BLVD STE 550
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90015-1474
Mailing Address - Country:US
Mailing Address - Phone:213-553-1850
Mailing Address - Fax:213-553-1864
Practice Address - Street 1:11050 ARTESIA BLVD
Practice Address - Street 2:
Practice Address - City:CERRITOS
Practice Address - State:CA
Practice Address - Zip Code:90703-2542
Practice Address - Country:US
Practice Address - Phone:562-860-8838
Practice Address - Fax:562-860-0248
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2007-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator