MARTIN LUTHER KINGJR-MULTI-SERVICE AMBULATORY CARE CENTER (NPI# 1770797805) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1770797805 |
Entity Type | Organization |
Organization Name | MARTIN LUTHER KINGJR-MULTI-SERVICE AMBULATORY CARE CENTER |
Practice Address |
12021 South Wilmington Ave Los Angeles CA 90059 |
Practice Telephone | 3106683972 |
Practice Fax Number | 3106872960 |
Enumeration Date | 2007-05-09 |
Last Update Date | 2009-03-12 |
Authorized Official Name | MS. CAROLYN S. CLARK (ADMINISTRATOR) |
Authorized Official Telephone | 3106685201 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 3336C0002X |
Pharmacy Specialization: Clinic Pharmacy |
PHE14222 | CA | Suppliers |
Street Address |
12021 SOUTH WILMINGTON AVE |
City | LOS ANGELES |
State | CA |
Zip Code | 90059 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1235759788 | Juan Jimenez Jr. | Technician, Pathology | 1860 E 120th St, Los Angeles, CA 90059 | 2020-04-24 |
1538717780 | Donald O Nwanze | Pharmacist | Mlk Outpatient Center (pharmacy), 1670 East 120th Street, Los Angeles, CA 90059 | 2019-08-30 |
1295391050 | Sheela Hoyle | Counselor | 836 East Saucer Lane, Los Angeles, CA 90059 | 2019-05-16 |
1750852471 | Carlos Tovar Sr. | Community Health Worker | 1720 E 120st, Los Angeles, CA 90059 | 2018-12-06 |
1699293910 | Amy Caryn Bolenbaugh | Recreation Therapist | 1720 E 120th Street, Los Angeles, CA 90059 | 2017-09-07 |
1417475757 | Scott Lee Jones | Recreation Therapist | Augustus F. Hawkins, 1720 E. 120th Street, Rm. 2196, Los Angeles, CA 90059 | 2017-09-07 |
1881118859 | Darlene Renee Tillman | Speech-Language Pathologist | 1670 E 120th Strret, Los Angeles, CA 90059 | 2017-08-01 |
1609306430 | Valda Therese Flores | Registered Nurse | 1670 E. 120th Street, Los Angeles, CA 90059 | 2017-06-14 |
1093244006 | Bongsill Chung | Registered Nurse | 1670 East 120th St, Los Angeles, CA 90059 | 2017-06-05 |
1730573395 | Apollonia Godoy | Registered Nurse | 1670 E. 120th St, 4th Floor, Module A, Los Angeles, CA 90059 | 2015-03-22 |
Find all providers in zip 90059 |
Taxonomy Code | 3336C0002X |
Grouping | Suppliers |
Classification | Pharmacy |
Specialization | Clinic Pharmacy |
A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist. |
Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1306263264 | University of Southern California | Pharmacy | 830 S Flower St, Los Angeles, CA 90017-4608 | 2014-03-27 |
1396867578 | County of Los Angeles - Auditor Controller | Pharmacy | 5850 S. Main St, Los Angeles, CA 90003-1215 | 2007-04-06 |
1649303306 | Women's & Children's Hospital Pharmacy | Pharmacy | 1240 N Mission Rd Trlr 7b, Los Angeles, CA 90033-1019 | 2007-03-13 |
1821146622 | Kaiser Foundation Health Plan Inc | Pharmacy | 1526 N Edgemont St Fl 1, Los Angeles, CA 90027-5260 | 2007-01-08 |
1033131107 | Aids Healthcare Foundation | Pharmacy | 1400 S Grand Ave Ste 801, Los Angeles, CA 90015-3068 | 2006-07-24 |
1215575873 | Lauren Andrea Tuason | Pharmacy | 1670 E 120th St, Los Angeles, CA 90059-3026 | 2019-12-13 |
1710437231 | San Vincente Women's Total Health Center Inc | Pharmacy | 6310 San Vicente Blvd, Suite 220, Los Angeles, CA 90048-5426 | 2016-10-07 |
1902355647 | East La Paz Family Medical Clinic Pa | Pharmacy | 3712 Whittier Blvd, Suite 1, Los Angeles, CA 90023-1733 | 2016-09-22 |
1558740852 | The Los Angeles Free Clinic | Pharmacy | 5205 Melrose Ave, Los Angeles, CA 90038-3144 | 2015-05-20 |
1063822872 | Anthony Martin Mills, M.d., Pharmacy Inc. | Pharmacy | 9201 W Sunset Blvd Ste 812, Los Angeles, CA 90069-3709 | 2014-05-01 |
Find all providers in LOS ANGELES |
City | LOS ANGELES |
Zip Code | 90059 |
Please comment or provide details below to improve the information on MARTIN LUTHER KINGJR-MULTI-SERVICE AMBULATORY CARE CENTER.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.