Healthcare Provider Details

I. General information

NPI: 1013311448
Provider Name (Legal Business Name): KOREAN HEALTH, EDUCATION, INFORMATION AND RESEARCH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2014
Last Update Date: 03/11/2021
Certification Date: 03/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3255 WILSHIRE BLVD STE 120
LOS ANGELES CA
90010-1405
US

IV. Provider business mailing address

3727 W 6TH ST STE 210
LOS ANGELES CA
90020-5108
US

V. Phone/Fax

Practice location:
  • Phone: 213-235-2500
  • Fax: 213-355-8714
Mailing address:
  • Phone: 213-247-4000
  • Fax: 213-427-4008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number StateCA

VIII. Authorized Official

Name: ERIN PAK
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 213-427-4000