Healthcare Provider Details

I. General information

NPI: 1487476560
Provider Name (Legal Business Name): COUNTY OF LOS ANGELES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/29/2024
Last Update Date: 10/29/2024
Certification Date: 10/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14445 OLIVE VIEW DR
SYLMAR CA
91342-1437
US

IV. Provider business mailing address

1000 S. FREMONT AVE, UNIT #9 BLDG A11, GROUND FLOOR, SUITE A11011
ALHAMBRA CA
91803-8801
US

V. Phone/Fax

Practice location:
  • Phone: 747-210-8000
  • Fax:
Mailing address:
  • Phone: 626-525-6076
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: MR. EDGAR SOLIS
Title or Position: CEO
Credential:
Phone: 747-210-3011