Healthcare Provider Details

I. General information

NPI: 1033542378
Provider Name (Legal Business Name): COUNTY OF LOS ANGELES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2013
Last Update Date: 07/17/2023
Certification Date: 07/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1670 E 120TH ST
LOS ANGELES CA
90059-3026
US

IV. Provider business mailing address

1000 S. FREMONT AVE UNIT #9, BLDG A11, GROUND FL, SUITE A11010
ALHAMBRA CA
91803-8801
US

V. Phone/Fax

Practice location:
  • Phone: 424-338-2196
  • Fax:
Mailing address:
  • Phone: 626-525-6076
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: QUENTIN O'BRIEN
Title or Position: CEO, AMBULATORY CARE NETWORK
Credential:
Phone: 213-288-9000