Provider Demographics
NPI:1962811265
Name:COUNTY OF LOS ANGELES
Entity type:Organization
Organization Name:COUNTY OF LOS ANGELES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:M
Authorized Official - Last Name:OLIVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:424-338-1001
Mailing Address - Street 1:1670 E. 120TH ST. MARTIN LUTHER KING JR. PHARMACY
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90059
Mailing Address - Country:US
Mailing Address - Phone:424-338-1930
Mailing Address - Fax:
Practice Address - Street 1:1670 EAST 120 TH STREET ,
Practice Address - Street 2:MARTIN LUTHER KING JR. PHARMACY
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90059-3019
Practice Address - Country:US
Practice Address - Phone:424-338-1930
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF LOS ANGELES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-08-12
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty