Healthcare Provider Details

I. General information

NPI: 1912292285
Provider Name (Legal Business Name): APAIT HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2011
Last Update Date: 06/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1730 W OLYMPIC BLVD SUITE 300
LOS ANGELES CA
90015-1019
US

IV. Provider business mailing address

1730 W OLYMPIC BLVD SUITE 100
LOS ANGELES CA
90015-1019
US

V. Phone/Fax

Practice location:
  • Phone: 213-553-1830
  • Fax: 213-553-1833
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License NumberCOMMUNITY CLINIC
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License NumberPRIMARY CARE CLINIC
License Number StateCA

VIII. Authorized Official

Name: JURY CANDELARIO
Title or Position: PRESIDENT/CEO
Credential:
Phone: 213-553-1830