Provider Demographics
NPI:1073259305
Name:H STREET CLINIC
Entity Type:Organization
Organization Name:H STREET CLINIC
Other - Org Name:CENTRAL NEIGHBORHOOD HEALTH FOUNDATION - NORWALK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CAO
Authorized Official - Prefix:
Authorized Official - First Name:ELEANOR
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-488-3111
Mailing Address - Street 1:2700 S GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90007-3301
Mailing Address - Country:US
Mailing Address - Phone:213-536-5815
Mailing Address - Fax:213-478-0172
Practice Address - Street 1:13122 STUDEBAKER RD
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CA
Practice Address - Zip Code:90650-2531
Practice Address - Country:US
Practice Address - Phone:562-888-5944
Practice Address - Fax:562-888-5945
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:H STREET CLINIC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-05-10
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty
No251B00000XAgenciesCase Management
No251X00000XAgenciesSupports Brokerage