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General NPI Number Information
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NPI Number | 1679182216
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Entity Type | Organization
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Legal Business Name | TORRANCE LOMITA COMMUNITY HEALTH CENTER
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Dates
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Enumeration Date | 07/29/2020
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Last Update Date | 07/29/2020
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Provider Practice Location Address
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Address Line | 25043 NARBONNE AVE
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City | LOMITA
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State | CA
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Zip | 90717-2101
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Country | US
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Telephone | 424-251-8388
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Fax | 424-251-8389
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Provider Business Mailing Address
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Address Line | 25043 NARBONNE AVE
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City | LOMITA
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State | CA
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Zip | 90717-2101
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Country | US
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Telephone | 424-251-8388
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DMITRIY GRINBERG
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Credential |
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Telephone | 424-251-8388
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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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 | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QF0050X
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Taxonomy Name | Non-Surgical Family Planning Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 261QX0100X
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Taxonomy Name | Occupational Medicine Clinic/Center
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License Number |
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License Number State |
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Taxonomy #8
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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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