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5525 Vineland Ave North Hollywood CA 91601-2730 | |
| (818) 753-4400 | |
| (818) 487-6922 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 5525 Vineland Ave, North Hollywood, California |
| Authorized Official Name and Position | Dulce M Ruiz (CONTRACTS AND GRANTS MANAGER) |
| Authorized Official Contact | 3107515442 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
4760 Sepulveda Blvd Culver City CA 90230-4820 Ph: (310) 390-6612 | 5525 Vineland Ave North Hollywood CA 91601-2730 Ph: (818) 753-4400 |
| NPI Number | 1952984270 |
|---|---|
| Provider Enumeration Date | 05/04/2021 |
| Last Update Date | 05/12/2021 |
| Certification Date | 05/12/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952984270 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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