| |
2100 W 3rd St Ste 220 Los Angeles CA 90057-1993 | |
(888) 499-9303 | |
(323) 889-7880 |
Full Name | |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 2100 W 3rd St Ste 220, Los Angeles, California |
Authorized Official Name and Position | Robert U. Young (VP, PATIENT FINANCIAL SERVICES) |
Authorized Official Contact | 3236222429 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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2040 Camfield Ave Los Angeles CA 90040-1501 Ph: (323) 622-2429 | 2100 W 3rd St Ste 220 Los Angeles CA 90057-1993 Ph: (888) 499-9303 |
NPI Number | 1083132849 |
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Provider Enumeration Date | 08/31/2017 |
Last Update Date | 07/21/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1083132849 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (California) | Primary |
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