Provider Demographics
NPI:1437377454
Name:KOREAN HEALTH EDUCATION INFORMATION AND RESEARCH CENTER
Entity Type:Organization
Organization Name:KOREAN HEALTH EDUCATION INFORMATION AND RESEARCH CENTER
Other - Org Name:KHEIR S. MARK TAPER FOUNDATION COMMUNITY CLINIC
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:
Authorized Official - Last Name:PAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:213-427-4000
Mailing Address - Street 1:3727 W 6TH ST STE 200
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90020-5108
Mailing Address - Country:US
Mailing Address - Phone:213-235-2500
Mailing Address - Fax:213-251-8647
Practice Address - Street 1:3727 W 6TH ST STE 200
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90020-5108
Practice Address - Country:US
Practice Address - Phone:213-235-2500
Practice Address - Fax:213-251-8647
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QF0400X
CA960001098261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHAP70813FOtherFAMILY PACT
CAFHC70813FMedicaid
CABCP70813FOtherCANCER DETECTION PROGRAM
CAEAP70813FOtherEAPC