Healthcare Provider Details

I. General information

NPI: 1306056858
Provider Name (Legal Business Name): COUNTY OF LOS ANGELES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 06/18/2021
Certification Date: 06/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

335 E AVENUE I
LANCASTER CA
93535-1916
US

IV. Provider business mailing address

335 E AVENUE I
LANCASTER CA
93535-1916
US

V. Phone/Fax

Practice location:
  • Phone: 661-948-8581
  • Fax:
Mailing address:
  • Phone: 661-948-8581
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. QUENTIN O'BRIEN
Title or Position: AMBULATORY NETWORK, CEO
Credential:
Phone: 213-288-9000