Healthcare Provider Details

I. General information

NPI: 1730266248
Provider Name (Legal Business Name): MACARTHUR PARK MEDICAL CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2228 WEST 7TH STREET
LOS ANGELES CA
90057
US

IV. Provider business mailing address

2228 WEST 7TH STREET
LOS ANGELES CA
90057
US

V. Phone/Fax

Practice location:
  • Phone: 213-383-5773
  • Fax: 213-383-5783
Mailing address:
  • Phone: 213-383-5773
  • Fax: 213-383-5783

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA30080
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA30080
License Number StateCA

VIII. Authorized Official

Name: ALICIA ZABELLA LAANO
Title or Position: MD
Credential: MD
Phone: 213-383-5773