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Organization
MARTIN LUTHER KING JR COMMUNITY MEDICAL FOUNDATION
Active
Organization
MARTIN LUTHER KING JR COMMUNITY MEDICAL FOUNDATION
Active
Other names
MARTIN LUTHER KING JR. COMMUNITY MEDICAL GROUP
Organization subpart
No
Provider details
NPI number
Authorized official
KURT STAUDER (PRESIDENT)
(424) 529-6755
Entity
Organization
Contact information
Practice address
12021 WILMINGTON AVE, BUILDING 11, SUITE 1000, LOS ANGELES, CA 90059
(424) 529-6755
(424) 338-8984
Mailing address
2215 W ROSECRANS AVE STE 22, COMPTON, CA 90222-3856
(424) 338-8760
(424) 338-8984
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
171R00000X
Interpreter
—
—
172V00000X
Community Health Worker
—
—
207QA0401X
Addiction Medicine (Family Medicine) Physician
—
—
207QA0505X
Adult Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
207RP1001X
Pulmonary Disease Physician
—
—
Other
Enumeration date
03/03/2020
Last updated
05/14/2024
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