MEDICARE: LOS ANGELES COMMUNITY HEALTH CENTER

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101Y00000X	Counselor
2	101YM0800X	Mental Health Counselor
3	2084P0805X	Geriatric Psychiatry Physician
4	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1780535088
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOS ANGELES COMMUNITY HEALTH CENTER

Provider Business Mailing Address
First Line	:	4300 CRENSHAW BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90008-4902
Country	:	US
Telephone Number	:	323-298-1668
Fax Number	:

Provider Business Practice Location Address
First Line	:	4300 CRENSHAW BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90008-4902
Country	:	US
Telephone Number	:	323-298-1668
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	DR. DANIEL DAVIDSON
Credential	:	MD
Telephone Number	:	310-212-1500

Provider Enumeration Date	:	02/04/2026
Last Update Date	:	02/04/2026

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Directions to “LOS ANGELES COMMUNITY HEALTH CENTER ” Practice Location

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