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General NPI Number Information
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NPI Number | 1386449270
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Entity Type | Organization
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Legal Business Name | CHINATOWN SERVICE CENTER
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Dates
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Enumeration Date | 02/15/2025
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Last Update Date | 02/15/2025
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Provider Practice Location Address
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Address Line | 2110 S HACIENDA BLVD
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City | HACIENDA HEIGHTS
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State | CA
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Zip | 91745-4242
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Country | US
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Telephone | 213-808-1790
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Fax |
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Provider Business Mailing Address
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Address Line | 711 W COLLEGE ST STE 388
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City | LOS ANGELES
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State | CA
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Zip | 90012-3177
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Country | US
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Telephone | 213-808-1700
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Fax |
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Authorized Official
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Title or Position | CLINIC OPERATIONS MANAGER
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Name | ANGELA CHING
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Credential |
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Telephone | 213-808-1740
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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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 | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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