Provider Demographics
NPI:1861673527
Name:AIDS HEALTHCARE FOUNDATION
Entity Type:Organization
Organization Name:AIDS HEALTHCARE FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:WALSH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-860-5348
Mailing Address - Street 1:6255 W SUNSET BLVD
Mailing Address - Street 2:SUITE 2100
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90028-7403
Mailing Address - Country:US
Mailing Address - Phone:323-860-5200
Mailing Address - Fax:323-962-8513
Practice Address - Street 1:6255 W SUNSET BLVD
Practice Address - Street 2:SUITE 2100
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90028-7403
Practice Address - Country:US
Practice Address - Phone:323-860-5200
Practice Address - Fax:323-962-8513
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AIDS HEALTHCARE FOUNDATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-11-21
Last Update Date:2007-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA261QC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAEAP70454FMedicaid