Provider Demographics
NPI:1255829271
Name:COUNTY OF LOS ANGELES - AUDITOR CONTROLLER
Entity Type:Organization
Organization Name:COUNTY OF LOS ANGELES - AUDITOR CONTROLLER
Other - Org Name:EAST SAN GABRIEL VALLEY SATELLITE MEDICAL HUB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF REVENUE MANAGEMENT, HEALTH SV
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:ALBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:213-288-7950
Mailing Address - Street 1:5555 FERGUSON DR STE 310-15
Mailing Address - Street 2:
Mailing Address - City:COMMERCE
Mailing Address - State:CA
Mailing Address - Zip Code:90022-5164
Mailing Address - Country:US
Mailing Address - Phone:323-914-7365
Mailing Address - Fax:
Practice Address - Street 1:4024 NORTH DURFEE RD
Practice Address - Street 2:
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91732
Practice Address - Country:US
Practice Address - Phone:626-450-8930
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF LOS ANGELES - AUDITOR CONTROLLER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-04-25
Last Update Date:2018-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care