| Chcada Roosevelt-ishc | |
|
456 S Mathews St Los Angeles CA 90033-4326 | |
| (323) 222-4591 | |
| Not Available |
| Full Name | Chcada Roosevelt-ishc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 456 S Mathews St, Los Angeles, California |
| Authorized Official Name and Position | James Hernandez (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 9144435473 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Chcada Roosevelt-ishc 1419 21st Street Sacramento CA 95811 Ph: (916) 443-5473 | Chcada Roosevelt-ishc 456 S Mathews St Los Angeles CA 90033-4326 Ph: (323) 222-4591 |
| NPI Number | 1801227087 |
|---|---|
| Provider Enumeration Date | 12/12/2013 |
| Last Update Date | 11/20/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801227087 | NPI | - | NPPES |
| 7884 | Other | CA | MEDI-CAL PROVIDER NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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