| Edward R. Roybal Chc | |
|
245 S Fetterly Ave Los Angeles CA 90022-1605 | |
| (323) 780-2214 | |
| Not Available |
| Full Name | Edward R. Roybal Chc |
|---|---|
| Speciality | Clinic/center |
| Location | 245 S Fetterly Ave, Los Angeles, California |
| Authorized Official Name and Position | Mark Corbet (INTERIM CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 3232262400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Edward R. Roybal Chc 245 S Fetterly Ave Los Angeles CA 90022-1605 Ph: (323) 780-2214 | Edward R. Roybal Chc 245 S Fetterly Ave Los Angeles CA 90022-1605 Ph: (323) 780-2214 |
| NPI Number | 1063425726 |
|---|---|
| Provider Enumeration Date | 08/14/2006 |
| Last Update Date | 03/23/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063425726 | NPI | - | NPPES |
| 05D0692541 | Other | CA | ROY CHC CLIA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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