Healthcare Provider Details
I. General information
NPI: 1578786018
Provider Name (Legal Business Name): COUNTY OF LOS ANGELES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/11/2007
Last Update Date: 10/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
501 N GLENDALE AVE
GLENDALE CA
91206-3312
US
IV. Provider business mailing address
501 N GLENDALE AVE
GLENDALE CA
91206-3312
US
V. Phone/Fax
- Phone: 818-500-3501
- Fax:
- Phone: 818-500-3501
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
QUENTIN
O'BRIEN
Title or Position: ACN, CEO
Credential:
Phone: 213-288-9000