| Livingstone Community Development Corporation | |
|
111 W Bastanchury Rd Unit 1a Fullerton CA 92835-2527 | |
| (714) 248-9500 | |
| (714) 622-4943 |
| Full Name | Livingstone Community Development Corporation |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 111 W Bastanchury Rd, Fullerton, California |
| Authorized Official Name and Position | Kyung I. Park (CEO) |
| Authorized Official Contact | 7142489500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Livingstone Community Development Corporation 111 W Bastanchury Rd Unit 1a Fullerton CA 92835-2527 Ph: (714) 248-9500 | Livingstone Community Development Corporation 111 W Bastanchury Rd Unit 1a Fullerton CA 92835-2527 Ph: (714) 248-9500 |
| NPI Number | 1881210318 |
|---|---|
| Provider Enumeration Date | 06/20/2020 |
| Last Update Date | 06/20/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881210318 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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