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2219 E 1st St Los Angeles CA 90033-3901 | |
(323) 269-0424 | |
(323) 780-9432 |
Full Name | |
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Speciality | Clinic/Center |
Location | 2219 E 1st St, Los Angeles, California |
Authorized Official Name and Position | Robert U. Young (VP, PATIENT FINANCIAL SERVICES) |
Authorized Official Contact | 3236222429 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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2040 Camfield Ave Los Angeles CA 90040-1501 Ph: (323) 622-2429 | 2219 E 1st St Los Angeles CA 90033-3901 Ph: (323) 269-0424 |
NPI Number | 1134492937 |
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Provider Enumeration Date | 02/10/2012 |
Last Update Date | 08/16/2019 |
Medicare PECOS PAC ID | 4284539966 |
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Medicare Enrollment ID | O20120314000068 |
Identifier | Type | State | Issuer |
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1134492937 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Joseph I Kang Md Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3755 Beverly Blvd, Ste 301, Los Angeles, CA 90004 Phone: 323-664-7777 | |
John L Sherman Md Amc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 8635 W 3rd St Ste 485w, Los Angeles, CA 90048 Phone: 310-855-8081 Fax: 310-855-0438 | |
Altamed Health Services Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5425 Pomona Blvd, Los Angeles, CA 90022 Phone: 323-832-7527 Fax: 323-832-7599 | |