Didi Hirsch At Jefferson Es | |
4091 W 139th St Rm 1 Hawthorne CA 90250-7303 | |
(310) 676-9423 | |
Not Available |
Full Name | Didi Hirsch At Jefferson Es |
---|---|
Speciality | Community/behavioral Health |
Location | 4091 W 139th St Rm 1, Hawthorne, California |
Authorized Official Name and Position | Dulce M Ruiz (CONTRACTS & GRANTS MANAGER) |
Authorized Official Contact | 3107515442 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Didi Hirsch At Jefferson Es 4760 Sepulveda Blvd Culver City CA 90230-4820 Ph: (310) 390-6612 | Didi Hirsch At Jefferson Es 4091 W 139th St Rm 1 Hawthorne CA 90250-7303 Ph: (310) 676-9423 |
NPI Number | 1225535925 |
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Provider Enumeration Date | 04/09/2018 |
Last Update Date | 10/06/2020 |
Certification Date | 10/06/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1225535925 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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