Provider Demographics
NPI:1083734263
Name:COUNTY OF LOS ANGELES
Entity Type:Organization
Organization Name:COUNTY OF LOS ANGELES
Other - Org Name:EDWARD ROYBAL COMP HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY SERVICES CHIEF
Authorized Official - Prefix:DR
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:P
Authorized Official - Last Name:LAU
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:323-780-2399
Mailing Address - Street 1:245 S FETTERLY AVE
Mailing Address - Street 2:ROOM 1401
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90022-1605
Mailing Address - Country:US
Mailing Address - Phone:323-780-2399
Mailing Address - Fax:323-780-9752
Practice Address - Street 1:245 S FETTERLY AVE
Practice Address - Street 2:ROOM 1401
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90022-1605
Practice Address - Country:US
Practice Address - Phone:323-780-2399
Practice Address - Fax:323-780-9752
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy