Healthcare Provider Details

I. General information

NPI: 1972471274
Provider Name (Legal Business Name): MARTIN LUTHER KING, JR. - LOS ANGELES (MLK-LA) HEALTHCARE CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2025
Last Update Date: 02/12/2026
Certification Date: 02/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12021 WILMINGTON AVE BLDG 11 SUITE 1500
LOS ANGELES CA
90059-3019
US

IV. Provider business mailing address

12021 WILMINGTON AVE BLDG 11 SUITE 1500
LOS ANGELES CA
90059-3019
US

V. Phone/Fax

Practice location:
  • Phone: 424-529-4001
  • Fax: 424-529-4002
Mailing address:
  • Phone: 424-529-4001
  • Fax: 424-529-4002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: ELAINE ELIZABETH BATCHLOR
Title or Position: CEO
Credential:
Phone: 424-338-8715