Provider Demographics
NPI:1912129131
Name:COUNTY OF LOS ANGELES
Entity Type:Organization
Organization Name:COUNTY OF LOS ANGELES
Other - Org Name:CHS - TWIN TOWERS PHARMACY
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIEF MEDICAL OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HENDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:213-893-5304
Mailing Address - Street 1:1000 S. FREMONT AVE., UNIT #9
Mailing Address - Street 2:BLDG A11, GROUND FL., SUITE A11010
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91803-8801
Mailing Address - Country:US
Mailing Address - Phone:626-525-6076
Mailing Address - Fax:
Practice Address - Street 1:450 BAUCHET STREET
Practice Address - Street 2:MEDICAL SERVICES BUILDING, RM #M4137
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90012-2907
Practice Address - Country:US
Practice Address - Phone:213-893-5566
Practice Address - Fax:323-415-1299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336I0012XSuppliersPharmacyInstitutional PharmacyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0513893OtherNCPDP PROVIDER ID