NPIMap

Organization Active NPI

The Los Angeles Free Clinic - Mobile Clinic

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
National Provider Identifier
1114668647
Registry record updated Jul 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
THE LOS ANGELES FREE CLINIC - MOBILE CLINIC
Practice address
6043 Hollywood Blvd
Los Angeles, CA 90028-5411
Phone
(323) 653-1990
NPI assigned
Apr 6, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Muriel Nouwezem
Title
Ceo
Phone
(323) 337-1707

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

6043 Hollywood Blvd
Los Angeles, CA 90028-5411

Mailing address

8405 Beverly Blvd
Los Angeles, CA 90048-3401
Phone (323) 653-1990

Other names 1

  • Saban Community Clinic - Mobile Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
The Los Angeles Free Clinic - Mobile Clinic7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

6043 Hollywood Blvd
Los Angeles, CA 90028
Phone (323) 653-1990

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1649203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658966400000",
    "number": "1114668647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8405 BEVERLY BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900483401",
            "telephone_number": "323-653-1990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6043 HOLLYWOOD BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900285411",
            "telephone_number": "323-653-1990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE LOS ANGELES FREE CLINIC - MOBILE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-06",
        "last_updated": "2022-07-28",
        "certification_date": "2022-07-28",
        "status": "A",
        "authorized_official_last_name": "NOUWEZEM",
        "authorized_official_first_name": "MURIEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "323-337-1707",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Saban Community Clinic - Mobile Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Saban Community Clinic - Mobile Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.