Provider Demographics
NPI:1386449270
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:213-808-1740
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:213-808-1700
Mailing Address - Fax:
Practice Address - Street 1:2110 S HACIENDA BLVD
Practice Address - Street 2:
Practice Address - City:HACIENDA HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:91745-4242
Practice Address - Country:US
Practice Address - Phone:213-808-1790
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHINATOWN SERVICE CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-02-15
Last Update Date:2025-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental