Healthcare Provider Details

I. General information

NPI: 1124152954
Provider Name (Legal Business Name): COUNTY OF LOS ANGELES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2007
Last Update Date: 06/26/2024
Certification Date: 06/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 N STATE ST RM A1C109
LOS ANGELES CA
90089-1001
US

IV. Provider business mailing address

1000 S. FREMONT AVE UNIT #9, BLDG A11, GROUND FL, SUITE A11010
ALHAMBRA CA
91803-8801
US

V. Phone/Fax

Practice location:
  • Phone: 323-409-3899
  • Fax: 323-441-4809
Mailing address:
  • Phone: 626-525-6076
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License NumberHPE17368
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number49214
License Number StateCA

VIII. Authorized Official

Name: MR. JORGE OROZCO
Title or Position: CEO
Credential:
Phone: 323-409-2800