Provider Demographics
NPI:1003230038
Name:APLA HEALTH & WELLNESS
Entity Type:Organization
Organization Name:APLA HEALTH & WELLNESS
Other - Org Name:APLA HEALTH & WELLNESS - DAVID GEFFEN CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:E
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:213-201-1456
Mailing Address - Street 1:611 S KINGSLEY DR
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90005-2319
Mailing Address - Country:US
Mailing Address - Phone:213-201-1623
Mailing Address - Fax:213-201-1595
Practice Address - Street 1:611 S KINGSLEY DR
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90005-2319
Practice Address - Country:US
Practice Address - Phone:213-201-1623
Practice Address - Fax:213-201-1595
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-11
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550002233261QF0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)