Healthcare Provider Details

I. General information

NPI: 1083003321
Provider Name (Legal Business Name): WHITE MEMORIAL COMMUNITY HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2015
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1828 E CESAR E CHAVEZ AVE STE 5000
LOS ANGELES CA
90033
US

IV. Provider business mailing address

1828 E CESAR E CHAVEZ AVE STE 6100
LOS ANGELES CA
90033-2597
US

V. Phone/Fax

Practice location:
  • Phone: 323-987-1200
  • Fax: 323-987-1212
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number550003845
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: GRACE FLOUTSIS
Title or Position: CEO
Credential: MD
Phone: 323-859-3627