Organization Name: | CENTRAL CITY COMM HLT CTR MOBILE UNIT |
NPI Number: | 1114258761 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SHARON FELIX (MANAGER) |
Mailing Address: | 5986 Central Avenue Los Angeles |
State: | CA US |
Postal Code: | 90001 |
Phone Number: | 3237287355 |
Fax Number: | 3237211877 |
NPI Enumeration Date: | 01/21/2010 |
NPI Last Update Date: | 01/21/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |