Provider Demographics
NPI:1386382430
Name:COUNTY OF LOS ANGELES
Entity type:Organization
Organization Name:COUNTY OF LOS ANGELES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AMBULATORY NETWORK, CEO
Authorized Official - Prefix:
Authorized Official - First Name:QUENTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:O'BRIEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:213-288-9000
Mailing Address - Street 1:1000 S. FREMONT AVE., UNIT #9
Mailing Address - Street 2:BLDG A11, GROUND FL., SUITE A11010
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91803-8801
Mailing Address - Country:US
Mailing Address - Phone:626-525-6076
Mailing Address - Fax:
Practice Address - Street 1:1212 PICO ST
Practice Address - Street 2:
Practice Address - City:SAN FERNANDO
Practice Address - State:CA
Practice Address - Zip Code:91340-3503
Practice Address - Country:US
Practice Address - Phone:818-627-3050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-26
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center