Healthcare Provider Details
I. General information
NPI: 1780146639
Provider Name (Legal Business Name): COUNTY OF LOS ANGELES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/01/2019
Last Update Date: 10/24/2023
Certification Date: 10/24/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3303 N BROADWAY
LOS ANGELES CA
90031-2803
US
IV. Provider business mailing address
3303 N. BROADWAY
LOS ANGELES CA
90031
US
V. Phone/Fax
- Phone: 323-362-1400
- Fax:
- Phone: 323-362-1400
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
QUENTIN
O'BRIEN
Title or Position: AMBULATORY NETWORK, CEO
Credential:
Phone: 213-288-9000