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Organization
NEW FAITH TRANSITIONAL LIVING
Active
Organization
NEW FAITH TRANSITIONAL LIVING
Active
Other names
West Gardena Community Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
ALICE BLACI (PRESIDENT)
(310) 436-7760
Entity
Organization
Contact information
Practice address
2233 W ROSECRANS AVE, GARDENA, CA 90249-2905
(310) 436-7760
Mailing address
2233 W ROSECRANS AVE, GARDENA, CA 90249-2905
(310) 436-7760
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20AA5193
CA
363A00000X
Physician Assistant
PA12545
CA
Other
Enumeration date
08/05/2015
Last updated
08/05/2015
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