Healthcare Provider Details

I. General information

NPI: 1891963393
Provider Name (Legal Business Name): URDC HUMAN SERVICES CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2008
Last Update Date: 02/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1460 N LAKE AVE SUITE 107
PASADENA CA
91104-2300
US

IV. Provider business mailing address

1460 N LAKE AVE SUITE 107
PASADENA CA
91104-2300
US

V. Phone/Fax

Practice location:
  • Phone: 626-398-3796
  • Fax: 626-398-3895
Mailing address:
  • Phone: 626-398-3796
  • Fax: 626-398-3895

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number StateCA

VIII. Authorized Official

Name: DR. AL SORKIN
Title or Position: EXECUTIVE DIRECTOR
Credential: PH.D.
Phone: 626-398-3796