Provider Demographics
NPI:1467752626
Name:ALL CARE ONE COMMUNITY HEALTH CENTER
Entity Type:Organization
Organization Name:ALL CARE ONE COMMUNITY HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KONONENKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-277-8900
Mailing Address - Street 1:7300 SANTA FE AVE.
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90255-5731
Mailing Address - Country:US
Mailing Address - Phone:323-277-8900
Mailing Address - Fax:323-277-8902
Practice Address - Street 1:7300 SANTA FE AVE.
Practice Address - Street 2:
Practice Address - City:HUNTINGTON PARK
Practice Address - State:CA
Practice Address - Zip Code:90255-7531
Practice Address - Country:US
Practice Address - Phone:323-277-8900
Practice Address - Fax:323-277-8902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-21
Last Update Date:2016-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy