Provider Demographics
NPI:1629632476
Name:SAINT CATHERINE FAMILY HEALTH CENTER
Entity Type:Organization
Organization Name:SAINT CATHERINE FAMILY HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:LIPELES
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:310-629-2447
Mailing Address - Street 1:12321 HAWTHORNE BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:CA
Mailing Address - Zip Code:90250-3832
Mailing Address - Country:US
Mailing Address - Phone:310-629-2447
Mailing Address - Fax:310-306-5555
Practice Address - Street 1:12321 HAWTHORNE BLVD STE A
Practice Address - Street 2:
Practice Address - City:HAWTHORNE
Practice Address - State:CA
Practice Address - Zip Code:90250-3832
Practice Address - Country:US
Practice Address - Phone:310-629-2447
Practice Address - Fax:310-306-5555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-26
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health