Healthcare Provider Details

I. General information

NPI: 1912746702
Provider Name (Legal Business Name): ALLMED OF LOS ANGELES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2024
Last Update Date: 05/07/2025
Certification Date: 05/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

672 S CARONDELET ST
LOS ANGELES CA
90057-3308
US

IV. Provider business mailing address

PO BOX 254502
SACRAMENTO CA
95865-4502
US

V. Phone/Fax

Practice location:
  • Phone: 213-384-3434
  • Fax:
Mailing address:
  • Phone: 213-384-3434
  • 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: YVETTE HARGROVE BROWN
Title or Position: GLOBAL ADMINISTRATOR
Credential:
Phone: 213-384-3434