Provider Demographics
NPI:1710368675
Name:BALDWIN HILLS CRENSHAW URGENT CARE
Entity Type:Organization
Organization Name:BALDWIN HILLS CRENSHAW URGENT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKENZIE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:323-294-4266
Mailing Address - Street 1:4303 DON DIABLO DR
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90008-4309
Mailing Address - Country:US
Mailing Address - Phone:323-294-4266
Mailing Address - Fax:323-294-4277
Practice Address - Street 1:3650 W MARTIN LUTHER KING JR BLVD STE 185
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90008-1799
Practice Address - Country:US
Practice Address - Phone:323-294-4266
Practice Address - Fax:323-294-4277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-16
Last Update Date:2015-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care