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General NPI Number Information
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NPI Number | 1962811265
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Entity Type | Organization
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Legal Business Name | COUNTY OF LOS ANGELES
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Dates
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Enumeration Date | 08/12/2014
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Last Update Date | 01/05/2024
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Provider Practice Location Address
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Address Line | 1670 EAST 120 TH STREET , MARTIN LUTHER KING JR. PHARMACY
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City | LOS ANGELES
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State | CA
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Zip | 90059-3019
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Country | US
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Telephone | 424-338-1930
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Fax |
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Provider Business Mailing Address
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Address Line | 1670 E. 120TH ST. MARTIN LUTHER KING JR. PHARMACY
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City | LOS ANGELES
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State | CA
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Zip | 90059
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Country | US
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Telephone | 424-338-1930
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Fax |
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | CYNTHIA M OLIVER
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Credential |
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Telephone | 424-338-1001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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