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General NPI Number Information
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NPI Number | 1073259305
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Entity Type | Organization
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Legal Business Name | H STREET CLINIC
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Dates
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Enumeration Date | 05/10/2022
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Last Update Date | 06/03/2022
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Provider Practice Location Address
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Address Line | 13122 STUDEBAKER RD
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City | NORWALK
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State | CA
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Zip | 90650-2531
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Country | US
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Telephone | 562-888-5944
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Fax | 562-888-5945
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Provider Business Mailing Address
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Address Line | 2700 S GRAND AVE
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City | LOS ANGELES
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State | CA
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Zip | 90007-3301
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Country | US
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Telephone | 213-536-5815
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Fax | 213-478-0172
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Authorized Official
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Title or Position | CAO
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Name | ELEANOR PEREZ
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Credential |
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Telephone | 626-488-3111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251X00000X
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Taxonomy Name | Supports Brokerage Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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