Healthcare Provider Details

I. General information

NPI: 1548392194
Provider Name (Legal Business Name): FILIPINO AMERICAN SERVICE GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2007
Last Update Date: 01/15/2026
Certification Date: 01/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 N PARK VIEW ST
LOS ANGELES CA
90026-5215
US

IV. Provider business mailing address

135 N PARK VIEW ST
LOS ANGELES CA
90026-5215
US

V. Phone/Fax

Practice location:
  • Phone: 213-487-9804
  • Fax: 213-487-9806
Mailing address:
  • Phone: 213-487-9804
  • Fax: 213-487-9806

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State

VIII. Authorized Official

Name: MARIA ELENA CORONEL
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 213-487-9804