Healthcare Provider Details

I. General information

NPI: 1760371645
Provider Name (Legal Business Name): FAMILY HEALTH CARE CENTERS OF GREATER LOS ANGELES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2025
Last Update Date: 10/10/2025
Certification Date: 10/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6001 E WASHINGTON BLVD STE 101
COMMERCE CA
90040-2455
US

IV. Provider business mailing address

6001 E WASHINGTON BLVD STE 101
COMMERCE CA
90040-2455
US

V. Phone/Fax

Practice location:
  • Phone: 562-928-9600
  • Fax:
Mailing address:
  • Phone: 562-928-9600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: RAQUEL R VILLA
Title or Position: C.E.O
Credential:
Phone: 562-776-5014