Provider Demographics
NPI:1215274592
Name:HHHCHC
Entity type:Organization
Organization Name:HHHCHC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SPA
Authorized Official - Prefix:MS
Authorized Official - First Name:AVA
Authorized Official - Middle Name:D
Authorized Official - Last Name:BATTLE
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:323-846-4103
Mailing Address - Street 1:5850 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90003-1215
Mailing Address - Country:US
Mailing Address - Phone:323-846-4103
Mailing Address - Fax:
Practice Address - Street 1:5850 S MAIN ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90003-1215
Practice Address - Country:US
Practice Address - Phone:323-846-4103
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-07
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA12601261QC1500X, 261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health