Pc Portals Comm Connections | |
3881 S Western Ave Los Angeles CA 90062-1105 | |
(323) 290-4348 | |
(323) 292-9220 |
Full Name | Pc Portals Comm Connections |
---|---|
Speciality | Community/behavioral Health |
Location | 3881 S Western Ave, Los Angeles, California |
Authorized Official Name and Position | James J. Balla (PRESIDENT & CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 6262545000 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Pc Portals Comm Connections 800 S Santa Anita Ave Arcadia CA 91006-6853 Ph: (626) 254-5000 | Pc Portals Comm Connections 3881 S Western Ave Los Angeles CA 90062-1105 Ph: (323) 290-4348 |
NPI Number | 1144357245 |
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Provider Enumeration Date | 02/27/2007 |
Last Update Date | 09/23/2021 |
Certification Date | 09/23/2021 |
Identifier | Type | State | Issuer |
---|---|---|---|
1144357245 | NPI | - | NPPES |
7690 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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