MEDICARE: KOREAN HEALTH EDUCATION INFORMATION AND RESEARCH 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)
2	261QP2300X	Primary Care Clinic/Center	960001098	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	HAP70813F	OTHER	CA	FAMILY PACT
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	BCP70813F	OTHER	CA	CANCER DETECTION PROGRAM
4	EAP70813F	OTHER	CA	EAPC

General Provider Information

NPI Number	:	1437377454
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KOREAN HEALTH EDUCATION INFORMATION AND RESEARCH CENTER

Provider Business Mailing Address
First Line	:	3727 W 6TH ST STE 200
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90020-5108
Country	:	US
Telephone Number	:	213-235-2500
Fax Number	:	213-251-8647

Provider Business Practice Location Address
First Line	:	3727 W 6TH ST STE 200
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90020-5108
Country	:	US
Telephone Number	:	213-235-2500
Fax Number	:	213-251-8647

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	ERIN PAK
Credential	:
Telephone Number	:	213-427-4000

Provider Enumeration Date	:	04/23/2007
Last Update Date	:	07/21/2022

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