| Center4 Health Medical Group | |
|
3701 Stocker St Ste 101 Los Angeles CA 90008-5145 | |
| (323) 290-2107 | |
| (323) 290-0632 |
| Full Name | Center4 Health Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 3701 Stocker St Ste 101, Los Angeles, California |
| Authorized Official Name and Position | Elizabeth Jean Covington (PHYSICIAN) |
| Authorized Official Contact | 3232902107 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Center4 Health Medical Group 3701 Stocker St Ste 101 Los Angeles CA 90008-5145 Ph: (323) 290-2107 | Center4 Health Medical Group 3701 Stocker St Ste 101 Los Angeles CA 90008-5145 Ph: (323) 290-2107 |
| NPI Number | 1346350386 |
|---|---|
| Provider Enumeration Date | 08/30/2006 |
| Last Update Date | 06/18/2008 |
| Medicare PECOS PAC ID | 6901071620 |
|---|---|
| Medicare Enrollment ID | O20111208000261 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346350386 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | G40179 (California) | Primary |
| Provider Name | Elizabeth J Covington |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447270988 PECOS PAC ID: 2163697889 Enrollment ID: I20111208000324 |
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