County of Los Angeles
Organization Active NPI Clinic/Center · Glendale, CA
NPI 1891708079 · NPPES record last updated Dec 18, 2018
Key facts
- NPI
- 1891708079
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinic/Center 261Q00000X
- Legal business name
- COUNTY OF LOS ANGELES
- Practice address
- 501 N Glendale Ave
Glendale, CA 91206-3312 - Phone
- (818) 500-3501
- NPI assigned
- Aug 15, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- COUNTY OF LOS ANGELES
Authorized official
- Name
- Ms. Carolyn Rhee
- Title
- Chief Executive Officer
- Phone
- (818) 364-3001
Other NPIs on the same Medicare enrollment 49
Corporate family (same tax ID) 24
Practitioners 8
-
Gyanesh Agrawal, M.D.
-
Bonnie Bayya, FNP-BC
-
Celerino Bacal Brucal, M.D.
-
Sony Alan Ta, MD
-
Molly Zielenbach, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031204001218 | CA | Part B Supplier - Clinic/Group Practice | 1850296534 |
Receives reassigned benefits from 1,953 practitioners 49 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Los Angeles, CA; Pacoima, CA; Monrovia, CA; North Hollywood, CA; Palmdale, CA; Pomona, CA; San Fernando, CA; Santa Monica, CA… |
National Provider Directory
- Tax ID family
- Usc Caruso Department Otolaryngology-Head and Neck Surgery
- Part of
- Usc Caruso Department Otolaryngology-Head and Neck Surgery
Locations
335 E Avenue K6
Lancaster, CA 93535
Phone (661) 417-4810
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | Yes |
Addresses
Primary practice location
501 N Glendale Ave
Glendale, CA 91206-3312
Mailing address
501 N Glendale Ave
Glendale, CA 91206-3312
Phone (818) 500-3501
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ZZW16076F | Medicaid | CA |
Other names
- Glendale Health Center
Other providers in Glendale, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 18, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.