| Sector Ii Ab3632 Program | |
|
12440 Firestone Blvd 3001 Norwalk CA 90650-4328 | |
| (562) 345-8000 | |
| Not Available |
| Full Name | Sector Ii Ab3632 Program |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 12440 Firestone Blvd, Norwalk, California |
| Authorized Official Name and Position | Lisa H. Wong (ACTING DIRECTOR) |
| Authorized Official Contact | 2137384601 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sector Ii Ab3632 Program 510 S Vermont Ave Los Angeles CA 90020-1992 Ph: (213) 738-4601 | Sector Ii Ab3632 Program 12440 Firestone Blvd 3001 Norwalk CA 90650-4328 Ph: (562) 345-8000 |
| NPI Number | 1558370544 |
|---|---|
| Provider Enumeration Date | 08/07/2006 |
| Last Update Date | 07/15/2022 |
| Certification Date | 07/15/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558370544 | NPI | - | NPPES |
| 1939 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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