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General NPI Number Information
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NPI Number | 1427446665
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Entity Type | Organization
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Legal Business Name | LATINO KIDS HEALTH
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Dates
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Enumeration Date | 12/22/2014
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Last Update Date | 04/14/2015
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Provider Practice Location Address
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Address Line | 901 W WHITTIER BLVD
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City | MONTEBELLO
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State | CA
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Zip | 90640-4737
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Country | US
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Telephone | 323-728-8588
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Fax | 323-728-4444
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Provider Business Mailing Address
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Address Line | 901 W WHITTIER BLVD
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City | MONTEBELLO
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State | CA
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Zip | 90640-4737
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Country | US
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Telephone | 323-728-8588
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Fax | 323-728-4444
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | MS. LINDA YOUNG
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Credential |
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Telephone | 323-728-8588
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 550002916
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License Number State | CA
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