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LOS ANGELES LGBT CENTER NPI 1548298532


NPI Information

NPI: 1548298532
Provider Name: LOS ANGELES LGBT CENTER

Former Legal Business Name: LOS ANGELES GAY AND LESBIAN COMMUNITY SERVICE CENTER

Classification: General Practice - 208D00000X
Entity Type: Organization

CLIA Number: 05D0543809

Address:
1625 SCHRADER BLVD
LOS ANGELES, CA
ZIP 90028
Phone: (323) 993-7500
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LOS ANGELES LGBT CENTER is a general practice in Los Angeles, CA. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee LOS ANGELES LGBT CENTER NPI is 1548298532. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Former Legal Business Name Is Los Angeles Gay And Lesbian Community Service Center.

The provider's business location address is:

1625 SCHRADER BLVD
LOS ANGELES, CA
ZIP 90028-213
Phone: (323) 993-7500
Fax: (323) 308-4015

The provider's authorized official is Darrel Cummings .
The authorized official title is Chief Of Staff and has the following contact phone number (323) 993-7605.

The CLIA number assigned to this NPI record is 05D0543809 - community clinic with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 6/29/2006 and was last updated on 4/26/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11041C0700XSocial WorkerClinicalNo
2106H00000XMarriage & Family TherapistNo
3133V00000XDietitian, RegisteredNo
42084P0800XPsychiatry & NeurologyPsychiatryNo
5208D00000XGeneral PracticeYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1CMM70532FMEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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