Healthcare Provider Details

I. General information

NPI: 1902568330
Provider Name (Legal Business Name): KOREAN HEALTH EDUCATION INFORMATION AND RESEARCH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2021
Last Update Date: 10/13/2021
Certification Date: 09/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3255 WILSHIRE BLVD STE 100
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: 213-235-2500
  • Fax: 213-427-4008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

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