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ANGELES COMPREHENSIVE COMMUNITY CLINIC INC. NPI 1457470684


NPI Information

NPI: 1457470684
Provider Name: ANGELES COMPREHENSIVE COMMUNITY CLINIC, INC.
Classification: Clinic/Center - 261Q00000X
Entity Type: Organization
Address:
3920 EAGLE ROCK BLVD.
SUITE A
LOS ANGELES, CA
ZIP 90065
Phone: (323) 255-5225
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ANGELES COMPREHENSIVE COMMUNITY CLINIC, INC. is a clinic center in Los Angeles, CA. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). ANGELES COMPREHENSIVE COMMUNITY CLINIC, INC. NPI is 1457470684. The provider is registered as an organization entity type.

The provider's business location address is:

3920 EAGLE ROCK BLVD.
SUITE A
LOS ANGELES, CA
ZIP 90065-606
Phone: (323) 255-5225
Fax: (323) 255-5229

The provider's authorized official is Liana Kazarova .
The authorized official title is Administrator and has the following contact phone number (323) 255-5225.

The enumeration date for this NPI number is 3/28/2007 and was last updated on 8/26/2014.


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
1261Q00000XClinic/Center550000708CALIFORNIAYes

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
11427003300OTHERCALIFORNIANPI
2W20815MEDICARE PINCALIFORNIA
31326349960OTHERCALIFORNIANPI
48370190013OTHERCALIFORNIACIGNA
5OXG182OTHERCALIFORNIABLUE CROSS
61811043474OTHERCALIFORNIANPI
7CB217375OTHERCALIFORNIAMEDICARE PTAN
8OO3991OTHERCALIFORNIAHEALTH NET
9ZZZ552884OTHERCALIFORNIABLUE SHIELD
10G56432F11OTHERCALIFORNIACARE 1ST
111457470684MEDICAIDCALIFORNIA
121427355981OTHERCALIFORNIANPI
1391355OTHERCALIFORNIAHEALTHY FAMILY ENROLLMENT ENTITY
14G56432MM2OTHERCALIFORNIALA CARE

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.