VENICE FAMILY CLINIC NPI 1790156917

NPI Information

VENICE FAMILY CLINIC is a federally qualified health center (fqhc) clinic center in Los Angeles, CA. VENICE FAMILY CLINIC NPI is 1790156917. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Other Name Is Lou Colen Health & Wellness Center.

The provider's business location address is:

4700 INGLEWOOD BLVD
SUITE # 101
LOS ANGELES, CA
ZIP 90230-896
Phone: (310) 392-8636
Fax: (310) 664-7913

The provider's authorized official is Mitesh G Popat .
The authorized official title is Chief Executive Officer and has the following contact phone number (310) 664-7901.

The CLIA number assigned to this NPI record is 05D2132228 - other - medical srvs to homeless with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/14/2015 and was last updated on 9/11/2023.

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:

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