Provider Demographics
NPI:1699248674
Name:CENTRAL NEIGHBORHOOD HEALTH FOUNDAT
Entity type:Organization
Organization Name:CENTRAL NEIGHBORHOOD HEALTH FOUNDAT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF BUSINESS OFFICE
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ARRIOLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:213-536-8514
Mailing Address - Street 1:714 W OLYMPIC BLVD STE 801
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90015-1440
Mailing Address - Country:US
Mailing Address - Phone:213-536-8515
Mailing Address - Fax:323-798-3015
Practice Address - Street 1:711 E VIA WANDA
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90805-6526
Practice Address - Country:US
Practice Address - Phone:213-536-8514
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENTRAL NEIGHBORHOOD HEALTH FOUNDAT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-01-02
Last Update Date:2019-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA261QP2300XMedicaid