| Martin Luther King Jr. Outpatient Center | |
|
1670 E 120th St Los Angeles CA 90059-3026 | |
| (424) 338-1000 | |
| Not Available |
| Full Name | Martin Luther King Jr. Outpatient Center |
|---|---|
| Speciality | Clinic/center |
| Location | 1670 E 120th St, Los Angeles, California |
| Authorized Official Name and Position | Virginia Perez (CHIEF, CONSOLIDATED BUSINESS OFFICE) |
| Authorized Official Contact | 3239147622 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Martin Luther King Jr. Outpatient Center 1670 E 120th St Los Angeles CA 90059-3026 Ph: (424) 338-2196 | Martin Luther King Jr. Outpatient Center 1670 E 120th St Los Angeles CA 90059-3026 Ph: (424) 338-1000 |
| NPI Number | 1245343052 |
|---|---|
| Provider Enumeration Date | 08/16/2006 |
| Last Update Date | 05/30/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245343052 | NPI | - | NPPES |
| FHC40578F | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (California) | Primary |
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