MEDICARE: CALIFORNIA INSTITUE OF HEALTH & SOCIAL SERVICES, INC.

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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1982412813
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CALIFORNIA INSTITUE OF HEALTH & SOCIAL SERVICES, INC.

Provider Business Mailing Address
First Line	:	8939 S SEPULVEDA BLVD STE 401
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90045-3646
Country	:	US
Telephone Number	:	310-645-5227
Fax Number	:	310-645-9840

Provider Business Practice Location Address
First Line	:	3756 SANTA ROSALIA DR STE 310
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90008-3615
Country	:	US
Telephone Number	:	310-645-5227
Fax Number	:	310-645-9840

Authorized Official
Title or Position	:	DIRECTOR OF OPERATIONS
Name	:	CYNTHIA MARSHALL
Credential	:
Telephone Number	:	310-645-5227

Provider Enumeration Date	:	12/23/2024
Last Update Date	:	12/23/2024

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