MEDICARE: AIDS HEALTHCARE FOUNDATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1154217545
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AIDS HEALTHCARE FOUNDATION

Provider Business Mailing Address
First Line	:	6255 W SUNSET BLVD FL 21
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90028-7422
Country	:	US
Telephone Number	:	323-860-5200
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 N BEACH ST STE 100
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76111-7070
Country	:	US
Telephone Number	:	817-916-5237
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	LYLE HONIG MOJICA
Credential	:
Telephone Number	:	323-860-5200

Provider Enumeration Date	:	06/13/2025
Last Update Date	:	06/13/2025

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Directions to “AIDS HEALTHCARE FOUNDATION ” Practice Location

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