Healthcare Provider Details
I. General information
NPI: 1760080881
Provider Name (Legal Business Name): FAMILY HEALTH CARE RESOURCES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/12/2020
Last Update Date: 06/21/2023
Certification Date: 07/20/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3444 WHITTIER BLVD STE A
LOS ANGELES CA
90023-1708
US
IV. Provider business mailing address
18375 VENTURA BLVD STE 539
TARZANA CA
91356-4218
US
V. Phone/Fax
- Phone: 213-413-3040
- Fax: 323-347-5680
- Phone: 213-413-3040
- Fax: 323-347-5680
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QC1500X |
| Taxonomy | Community Health Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QF0400X |
| Taxonomy | Federally Qualified Health Center (FQHC) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
HANY
MALEK
Title or Position: CEO
Credential:
Phone: 213-413-3040