MEDICARE: LOS ANGELES LGBT CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QF0400X	Federally Qualified Health Center (FQHC)

General Provider Information

NPI Number	:	1225599178
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOS ANGELES LGBT CENTER

Provider Business Mailing Address
First Line	:	1625 SCHRADER BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90028-6213
Country	:	US
Telephone Number	:	323-993-7555
Fax Number	:

Provider Business Practice Location Address
First Line	:	3055 WILSHIRE BLVD STE 360
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90010-1108
Country	:	US
Telephone Number	:	323-993-2900
Fax Number	:

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	ROBYN GOLDMAN
Credential	:
Telephone Number	:	323-993-8948

Provider Enumeration Date	:	03/25/2019
Last Update Date	:	10/23/2025

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