Provider Demographics
NPI:1578961892
Name:L.A. CARE
Entity Type:Organization
Organization Name:L.A. CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICOM MANAGER, PHARMACY & FORMULA
Authorized Official - Prefix:DR
Authorized Official - First Name:GAYLE
Authorized Official - Middle Name:STEPHENS
Authorized Official - Last Name:BUTLER
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:213-694-1250
Mailing Address - Street 1:1055 W 7TH ST FL 10
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90017-2750
Mailing Address - Country:US
Mailing Address - Phone:213-694-1250
Mailing Address - Fax:
Practice Address - Street 1:1055 W 7TH ST FL 10
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90017-2750
Practice Address - Country:US
Practice Address - Phone:213-694-1250
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-18
Last Update Date:2014-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49118302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization