Provider Demographics
NPI:1720451396
Name:LOS ANGELES LGBT CENTER
Entity Type:Organization
Organization Name:LOS ANGELES LGBT CENTER
Other - Org Name:LOS ANGELES LGBT CENTER-WEHO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARCOS
Authorized Official - Middle Name:
Authorized Official - Last Name:BELTRAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:213-466-5012
Mailing Address - Street 1:8745 SANTA MONICA BLVD
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:WEST HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90069-4507
Mailing Address - Country:US
Mailing Address - Phone:323-993-7440
Mailing Address - Fax:
Practice Address - Street 1:8745 SANTA MONICA BLVD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90069-4507
Practice Address - Country:US
Practice Address - Phone:323-993-7440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE LOS ANGELES LGBT CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-11-04
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care