Healthcare Provider Details

I. General information

NPI: 1891826947
Provider Name (Legal Business Name): SPECIAL SERVICE FOR GROUPS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2007
Last Update Date: 10/21/2025
Certification Date: 10/21/2025
Deactivation Date: 07/31/2025
Reactivation Date: 10/21/2025

III. Provider practice location address

5715 S BROADWAY
LOS ANGELES CA
90037-4131
US

IV. Provider business mailing address

905 E 8TH ST
LOS ANGELES CA
90021-1848
US

V. Phone/Fax

Practice location:
  • Phone: 323-948-0444
  • Fax: 323-948-0443
Mailing address:
  • Phone: 213-553-1800
  • Fax: 213-553-1822

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: HERBERT K HATANAKA
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 213-553-1800