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General NPI Number Information
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NPI Number | 1215274592
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Entity Type | Organization
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Legal Business Name | HHHCHC
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Dates
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Enumeration Date | 01/07/2013
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Last Update Date | 01/07/2013
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Provider Practice Location Address
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Address Line | 5850 S MAIN ST
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City | LOS ANGELES
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State | CA
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Zip | 90003-1215
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Country | US
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Telephone | 323-846-4103
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Fax |
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Provider Business Mailing Address
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Address Line | 5850 S MAIN ST
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City | LOS ANGELES
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State | CA
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Zip | 90003-1215
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Country | US
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Telephone | 323-846-4103
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Fax |
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Authorized Official
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Title or Position | SPA
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Name | MS. AVA D. BATTLE
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Credential | PA
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Telephone | 323-846-4103
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number | PA12601
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | PA12601
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License Number State | CA
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