Provider Demographics
NPI:1689961302
Name:PEOPLE'S COMMUNITY CLINIC
Entity Type:Organization
Organization Name:PEOPLE'S COMMUNITY CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HR DIRECTOR / ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:HOURY
Authorized Official - Middle Name:
Authorized Official - Last Name:KARABIBERJIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-928-5052
Mailing Address - Street 1:4139 VERDUGO RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90065-3820
Mailing Address - Country:US
Mailing Address - Phone:323-928-5086
Mailing Address - Fax:323-274-4604
Practice Address - Street 1:4139 VERDUGO RD
Practice Address - Street 2:SUITE A
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90065-3820
Practice Address - Country:US
Practice Address - Phone:323-928-5086
Practice Address - Fax:323-274-4604
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-01
Last Update Date:2018-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA261QC1500X, 261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care