Provider Demographics
NPI:1215757505
Name:CHINATOWN SERVICE CENTER
Entity type:Organization
Organization Name:CHINATOWN SERVICE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:213-808-1792
Mailing Address - Street 1:711 W COLLEGE ST STE 388
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90012-3177
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:726 E MAIN ST SUITE B
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-4082
Practice Address - Country:US
Practice Address - Phone:626-773-3388
Practice Address - Fax:626-773-3389
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHINATOWN SERVICE CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-10-12
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)