| Independence Community Treatment Clinic | |
|
10833 E Avenue R Room 118, 119, 217 Littlerock CA 93543-4106 | |
| (818) 776-1755 | |
| Not Available |
| Full Name | Independence Community Treatment Clinic |
|---|---|
| Speciality | Clinic/center - Community Health |
| Location | 10833 E Avenue R, Littlerock, California |
| Authorized Official Name and Position | Alex Branzburg (PROGRAM DIRECTOR) |
| Authorized Official Contact | 8187761755 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Independence Community Treatment Clinic 19231 Victory Blvd Suite 554 Reseda CA 91335-6308 Ph: () - | Independence Community Treatment Clinic 10833 E Avenue R Room 118, 119, 217 Littlerock CA 93543-4106 Ph: (818) 776-1755 |
| NPI Number | 1134366115 |
|---|---|
| Provider Enumeration Date | 01/14/2009 |
| Last Update Date | 12/18/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134366115 | NPI | - | NPPES |
| 196856000 | Medicaid | CA | |
| CMM70956F | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | 960001358 (California) | Primary |
County Of Los Angeles Auditor Controller Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8201 East Pearblossom Hwy, Littlerock, CA 93543 Phone: 661-945-8382 | |
County Of Los Angeles Auditor Controller Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8201 East Pearblossom Hwy, Littlerock, CA 93543 Phone: 661-945-8382 | |
County Of Los Angeles Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8201 East Pearblossom Highway, Littlerock, CA 93543 Phone: 661-945-8382 | |
County Of Los Angeles Auditor Controller Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8201 East Pearblossom Hwy, Littlerock, CA 93543 Phone: 661-945-8382 | |
County Of Los Angeles Auditor Controller Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8201 East Pearblossom Hwy, Littlerock, CA 93543 Phone: 661-945-8382 | |
County Of Los Angeles Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8201 East Pearblossom Hwy, Littlerock, CA 93543 Phone: 661-945-8382 |