Provider Demographics
NPI:1396580650
Name:CHINATOWN SERVICE CENTER
Entity type:Organization
Organization Name:CHINATOWN SERVICE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:K
Authorized Official - Last Name:NG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:213-808-1701
Mailing Address - Street 1:711 W COLLEGE ST STE 388
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90012-3177
Mailing Address - Country:US
Mailing Address - Phone:213-808-1740
Mailing Address - Fax:213-680-9427
Practice Address - Street 1:711 W COLLEGE ST STE M88
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90012-3185
Practice Address - Country:US
Practice Address - Phone:213-808-1792
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHINATOWN SERVICE CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-06-28
Last Update Date:2024-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty