Healthcare Provider Details

I. General information

NPI: 1124955323
Provider Name (Legal Business Name): PREMIER MANAGEMENT ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8510 S WESTERN AVE
LOS ANGELES CA
90047-3052
US

IV. Provider business mailing address

8510 S WESTERN AVE
LOS ANGELES CA
90047-3052
US

V. Phone/Fax

Practice location:
  • Phone: 323-702-1252
  • Fax:
Mailing address:
  • Phone: 323-702-1252
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TAMICA KING
Title or Position: OWNER
Credential:
Phone: 323-702-1252