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Organization
CHINATOWN SERVICE CENTER
Active
Organization
CHINATOWN SERVICE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD LEW DMD (CHIEF DENTIST)
(213) 808-1790
Entity
Organization
Contact information
Practice address
555 W LAS TUNAS DR, SAN GABRIEL, CA 91776-1134
(626) 576-7616
Mailing address
767 N HILL ST, SUITE 400, LOS ANGELES, CA 90012-2343
(213) 808-1702
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
960000220
CA
Other
Enumeration date
05/15/2017
Last updated
02/11/2022
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