MEDICARE: EL PROYECTO DEL BARRIO-EAST LA

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)		CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1962564823
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EL PROYECTO DEL BARRIO-EAST LA

Provider Business Mailing Address
First Line	:	8902 WOODMAN AVE
Second Line	:
City	:	ARLETA
State	:	CA
Zip	:	91331-6401
Country	:	US
Telephone Number	:	818-830-7133
Fax Number	:

Provider Business Practice Location Address
First Line	:	4732 E 3RD ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90022-1617
Country	:	US
Telephone Number	:	323-261-5424
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT CEO
Name	:	CORINNE SANCHEZ
Credential	:	ESQ
Telephone Number	:	818-830-7133

Provider Enumeration Date	:	12/15/2006
Last Update Date	:	08/22/2020

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