Organization Active NPI

Los Angeles Community Clinic, Inc.

  • Community Health Clinic/Center
  • Los Angeles, CA
National Provider Identifier
1609280346
Registry record updated Nov 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
Legal business name
LOS ANGELES COMMUNITY CLINIC, INC.
Practice address
1830 W Olympic Blvd
Suite 124
Los Angeles, CA 90006-3734
Phone
(213) 383-1183
Fax
(213) 383-1184
NPI assigned
Jun 19, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2021

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

Authorized official

Name
Mr. Brandon S. Oh
Title
Ceo/Administrator
Phone
(323) 852-3245

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X Primary

Addresses

Primary practice location

1830 W Olympic Blvd
Suite 124
Los Angeles, CA 90006-3734

Mailing address

1830 W Olympic Blvd
Suite 124
Los Angeles, CA 90006-3734
Phone (323) 852-3245

National Provider Directory

National Provider Directory

Locations

1830 W Olympic Blvd
Ste 12
Los Angeles, CA 90006
Phone (213) 383-1183

NPI Registry JSON

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

{
    "created_epoch": "1403136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637884800000",
    "number": "1609280346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1830 W OLYMPIC BLVD",
            "address_2": "SUITE 124",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900063734",
            "telephone_number": "323-852-3245",
            "fax_number": "213-325-6618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1830 W OLYMPIC BLVD",
            "address_2": "SUITE 124",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900063734",
            "telephone_number": "213-383-1183",
            "fax_number": "213-383-1184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOS ANGELES COMMUNITY CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-19",
        "last_updated": "2021-11-26",
        "certification_date": "2021-11-26",
        "status": "A",
        "authorized_official_last_name": "OH",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "CEO/ADMINISTRATOR",
        "authorized_official_telephone_number": "323-852-3245",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Nov 26, 2021; 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.