| Calif Hospital Medical Ctr-calif Behavioral Health Clinic | |
|
1400 S Grand Ave Ste 600 Los Angeles CA 90015-3048 | |
| (213) 742-6250 | |
| (213) 742-6312 |
| Full Name | Calif Hospital Medical Ctr-calif Behavioral Health Clinic |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1400 S Grand Ave Ste 600, Los Angeles, California |
| Authorized Official Name and Position | Rebecca Cheng (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 2137425910 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Calif Hospital Medical Ctr-calif Behavioral Health Clinic 1401 S Grand Ave Los Angeles CA 90015-3010 Ph: (213) 742-5778 | Calif Hospital Medical Ctr-calif Behavioral Health Clinic 1400 S Grand Ave Ste 600 Los Angeles CA 90015-3048 Ph: (213) 742-6250 |
| NPI Number | 1013049626 |
|---|---|
| Provider Enumeration Date | 03/09/2007 |
| Last Update Date | 07/14/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013049626 | NPI | - | NPPES |
| 7590 | Other | CA | MEDI-CAL PROVIDER ID |
| 10259403 | Other | CA | DMH VENDOR NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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