Healthcare Provider Details

I. General information

NPI: 1417421850
Provider Name (Legal Business Name): HEALTH ACCESS FOR ALL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2019
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1030 GARDENA BLVD
GARDENA CA
90247-4956
US

IV. Provider business mailing address

PO BOX 57130
LOS ANGELES CA
90057-0130
US

V. Phone/Fax

Practice location:
  • Phone: 424-222-8800
  • Fax: 424-222-8999
Mailing address:
  • Phone: 213-413-2222
  • Fax: 213-483-1711

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: MARIANA CANELA
Title or Position: COO
Credential:
Phone: 213-413-4888