Healthcare Provider Details

I. General information

NPI: 1912129131
Provider Name (Legal Business Name): COUNTY OF LOS ANGELES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 09/29/2023
Certification Date: 09/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 BAUCHET STREET MEDICAL SERVICES BUILDING, RM #M4137
LOS ANGELES CA
90012-2907
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: 213-893-5566
  • Fax: 323-415-1299
Mailing address:
  • Phone: 626-525-6076
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DR. SEAN HENDERSON
Title or Position: CHIEF MEDICAL OFFICER
Credential:
Phone: 213-893-5304