Healthcare Provider Details

I. General information

NPI: 1003951708
Provider Name (Legal Business Name): ASIAN PACIFIC HEALTH CARE VENTURE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3939 TRACY ST
LOS ANGELES CA
90027-3207
US

IV. Provider business mailing address

3939 TRACY ST
LOS ANGELES CA
90027-3207
US

V. Phone/Fax

Practice location:
  • Phone: 323-665-1129
  • Fax: 323-665-1104
Mailing address:
  • Phone: 323-665-1129
  • Fax: 323-665-1104

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1000X
TaxonomyStudent Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JEANNE AGUINALDO
Title or Position: YOUTH SERVICES MANAGER
Credential:
Phone: 323-644-3880