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NPI Code Detail

MEDICARE: PLAZA COMMUNITY CENTER, INC.

MEDICARE: PLAZA COMMUNITY CENTER, INC.
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
1101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1255630810
Entity Type Code : Organization
Provider Name (Legal Business Name) : PLAZA COMMUNITY CENTER, INC.
Provider Business Mailing Address
First Line : 4018 CITY TERRACE DR
Second Line :
City : LOS ANGELES
State : CA
Zip : 90063-1242
Country : US
Telephone Number : 323-267-9749
Fax Number : 323-267-0375
Provider Business Practice Location Address
First Line : 4018 CITY TERRACE DR
Second Line :
City : LOS ANGELES
State : CA
Zip : 90063-1242
Country : US
Telephone Number : 323-267-9749
Fax Number : 323-267-0375
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : DR. GABRIEL BUELNA
Credential : PH.D.
Telephone Number : 323-267-9749
Provider Enumeration Date : 03/22/2011
Last Update Date : 03/22/2011

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Directions to “PLAZA COMMUNITY CENTER, INC. ” Practice Location

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