# BIENVENIDOS CHILDREN'S CENTER, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Bienvenidos Community Health Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124153820
- **Authorized official:** JACOBUS VAN DER COLFF (CHIEF FINANCIAL OFFICER)
- **Authorized official phone:** (213) 785-5923

## Contact information

- **Practice address:** 316 W 2ND ST, SUITE 800, LOS ANGELES, CA 90012-3504
- **Practice address phone:** (213) 785-5906
- **Practice address fax:** (213) 785-5914
- **Mailing address:** 316 W. 2ND STREET, SUITE 800, LOS ANGELES, CA 90012
- **Mailing address phone:** (213) 785-5922
- **Mailing address fax:** (213) 785-5914

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | A63662 | CA | Yes |

## Other

- **Enumeration date:** 02/22/2007
- **Last updated:** 08/07/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | CMM70881F | — | CA |
| 05 | — | EAP70881F | — | CA |