Provider Demographics
NPI:1790051423
Name:FAMILY HEALTH CARE CENTERS OF GREATER LOS ANGELES, INC.
Entity Type:Organization
Organization Name:FAMILY HEALTH CARE CENTERS OF GREATER LOS ANGELES, INC.
Other - Org Name:HAWAIIAN GARDENS HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RAQUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:VILLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-928-9600
Mailing Address - Street 1:6001 E WASHINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:COMMERCE
Mailing Address - State:CA
Mailing Address - Zip Code:90040-2451
Mailing Address - Country:US
Mailing Address - Phone:562-928-9600
Mailing Address - Fax:562-927-6974
Practice Address - Street 1:12113 WOODRUFF AVE
Practice Address - Street 2:SUITE A
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241
Practice Address - Country:US
Practice Address - Phone:562-231-5600
Practice Address - Fax:562-803-1430
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FAMILY HEALTH CARE CENTERS OF GREATER LOS ANGELES, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-03-27
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health