MEDICARE: PUENTE LEARNING 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	251300000X	Local Education Agency (LEA)

General Provider Information

NPI Number	:	1942010582
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PUENTE LEARNING CENTER

Provider Business Mailing Address
First Line	:	501 S BOYLE AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90033-3816
Country	:	US
Telephone Number	:	323-780-8900
Fax Number	:	323-780-0359

Provider Business Practice Location Address
First Line	:	501 S BOYLE AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90033-3816
Country	:	US
Telephone Number	:	323-780-8900
Fax Number	:	323-780-0359

Authorized Official
Title or Position	:	SENIOR GRANTS OFFICER
Name	:	MS. ANDREA GRIEGO
Credential	:
Telephone Number	:	323-780-7545

Provider Enumeration Date	:	01/07/2025
Last Update Date	:	01/07/2025

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