| 3c Community Clinic | |
|
3030 W Olympic Blvd Ste 206 Los Angeles CA 90006-6506 | |
| (310) 658-4494 | |
| Not Available |
| Full Name | 3c Community Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 3030 W Olympic Blvd Ste 206, Los Angeles, California |
| Authorized Official Name and Position | Jaesung Kim (CEO) |
| Authorized Official Contact | 2133222666 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| 3c Community Clinic 3030 W Olympic Blvd Ste 206 Los Angeles CA 90006-6506 Ph: () - | 3c Community Clinic 3030 W Olympic Blvd Ste 206 Los Angeles CA 90006-6506 Ph: (310) 658-4494 |
| NPI Number | 1093167850 |
|---|---|
| Provider Enumeration Date | 07/05/2016 |
| Last Update Date | 05/12/2023 |
| Medicare PECOS PAC ID | 4880976406 |
|---|---|
| Medicare Enrollment ID | O20170116000484 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093167850 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Youngwook Kim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881852432 PECOS PAC ID: 0749409936 Enrollment ID: I20140922000466 |
| Provider Name | Jae Hyung Cho |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1407165434 PECOS PAC ID: 6901030691 Enrollment ID: I20160411001449 |
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