| Lake Los Angeles Community Clinic | |
|
16921 E Avenue O Ste G Palmdale CA 93591-3045 | |
| (661) 945-8444 | |
| Not Available |
| Full Name | Lake Los Angeles Community Clinic |
|---|---|
| Speciality | Clinic/center |
| Location | 16921 E Avenue O Ste G, Palmdale, California |
| Authorized Official Name and Position | Quentin O'brien (ACN, CEO) |
| Authorized Official Contact | 2132889000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Los Angeles Community Clinic 16921 E Avenue O Ste G Palmdale CA 93591-3045 Ph: (661) 945-8444 | Lake Los Angeles Community Clinic 16921 E Avenue O Ste G Palmdale CA 93591-3045 Ph: (661) 945-8444 |
| NPI Number | 1639209927 |
|---|---|
| Provider Enumeration Date | 03/06/2007 |
| Last Update Date | 10/03/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639209927 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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