MEDICARE: AIDS HEALTHCARE FOUNDATION

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	261QH0100X	Health Service Clinic/Center	960001164	CA

General Provider Information

NPI Number	:	1598740177
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AIDS HEALTHCARE FOUNDATION

Provider Business Mailing Address
First Line	:	6255 W SUNSET BLVD FL 21
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90028-7422
Country	:	US
Telephone Number	:	323-860-5200
Fax Number	:	833-241-7615

Provider Business Practice Location Address
First Line	:	4940 VAN NUYS BLVD STE 200
Second Line	:
City	:	SHERMAN OAKS
State	:	CA
Zip	:	91403-1741
Country	:	US
Telephone Number	:	818-380-2626
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	LYLE HONIG MOJICA
Credential	:
Telephone Number	:	323-860-5305

Provider Enumeration Date	:	12/07/2005
Last Update Date	:	03/06/2024

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Practice Fax: 818-783-7781

Directions to “AIDS HEALTHCARE FOUNDATION ” Practice Location

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