=====================================================
General NPI Number Information
=====================================================
NPI Number | 1336905199
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FUTURE HOPE OUTREACH FOUNDATION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/27/2024
-----------------------------------------------------
Last Update Date | 05/20/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2628 E CESAR E CHAVEZ AVE
-----------------------------------------------------
City | LOS ANGELES
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90033-3006
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 323-354-4565
-----------------------------------------------------
Fax | 323-354-4461
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2521 HUNTINGTON DR
-----------------------------------------------------
City | SAN MARINO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91108-2602
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR
-----------------------------------------------------
Name | LILIA XU
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 323-354-4565
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QC1500X
-----------------------------------------------------
Taxonomy Name | Community Health Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------