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General NPI Number Information
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NPI Number | 1609748714
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Entity Type | Organization
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Legal Business Name | UNION STREET COMMUNITY HEALTH CENTER
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Dates
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Enumeration Date | 09/18/2025
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Last Update Date | 09/19/2025
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Provider Practice Location Address
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Address Line | 7840 IMPERIAL HWY STE B
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City | DOWNEY
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State | CA
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Zip | 90242-3457
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Country | US
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Telephone | 424-258-0124
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Fax |
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Provider Business Mailing Address
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Address Line | 955 CARRILLO DR STE 750
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City | LOS ANGELES
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State | CA
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Zip | 90048-5400
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MICHAEL GHODS
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Credential | M.D.
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Telephone | 424-258-0124
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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