Provider Demographics
NPI:1790308005
Name:KOREAN HEALTH, EDUCATION, INFORMATION AND RESEARCH CENTER
Entity Type:Organization
Organization Name:KOREAN HEALTH, EDUCATION, INFORMATION AND RESEARCH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:
Authorized Official - Last Name:PAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:213-235-2500
Mailing Address - Street 1:3727 W 6TH ST STE 210
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90020-5108
Mailing Address - Country:US
Mailing Address - Phone:213-235-2500
Mailing Address - Fax:213-427-4008
Practice Address - Street 1:621 S VIRGIL AVE STE 401
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90005-4040
Practice Address - Country:US
Practice Address - Phone:213-235-2500
Practice Address - Fax:213-427-4008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-20
Last Update Date:2020-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care