Provider Demographics
NPI:1396867578
Name:COUNTY OF LOS ANGELES
Entity Type:Organization
Organization Name:COUNTY OF LOS ANGELES
Other - Org Name:HUBERT H HUMPHREY COMP HEALTH CTR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY SERVICES CHIEF
Authorized Official - Prefix:MRS
Authorized Official - First Name:IN (VERONICA)
Authorized Official - Middle Name:SOON
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:RPH, JD
Authorized Official - Phone:323-846-4130
Mailing Address - Street 1:5850 S. MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90003-1215
Mailing Address - Country:US
Mailing Address - Phone:323-846-4316
Mailing Address - Fax:323-231-7627
Practice Address - Street 1:5850 S. MAIN ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90003-1215
Practice Address - Country:US
Practice Address - Phone:323-846-4316
Practice Address - Fax:323-231-7627
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-06
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA173843336C0002X
CAPHE173843336C0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy