| Gold Star Community Health Center, Inc. | |
|
6343 Vineland Ave N Hollywood CA 91606-3721 | |
| (747) 877-2789 | |
| Not Available |
| Full Name | Gold Star Community Health Center, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 6343 Vineland Ave, N Hollywood, California |
| Authorized Official Name and Position | Ella Undzhyan (CEO) |
| Authorized Official Contact | 7478772788 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gold Star Community Health Center, Inc. 6343 Vineland Ave N Hollywood CA 91606-3721 Ph: (747) 877-2789 | Gold Star Community Health Center, Inc. 6343 Vineland Ave N Hollywood CA 91606-3721 Ph: (747) 877-2789 |
| NPI Number | 1124696349 |
|---|---|
| Provider Enumeration Date | 06/14/2021 |
| Last Update Date | 06/14/2021 |
| Certification Date | 06/14/2021 |
| Medicare PECOS PAC ID | 3870996077 |
|---|---|
| Medicare Enrollment ID | O20210726003002 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124696349 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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