Healthcare Provider Details

I. General information

NPI: 1396329199
Provider Name (Legal Business Name): KOREAN HEALTH EDUCATION INFORMATION AND RESEARCH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2021
Last Update Date: 05/07/2021
Certification Date: 05/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3750 W 6TH ST STE 114
LOS ANGELES CA
90020-5100
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:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SHADMAN CHOWDHURY
Title or Position: PRACTICE DEVELOPMENT SPECIALIST
Credential:
Phone: 213-235-1212