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Organization
LA COMMUNITY CARE MEDICAL
Active
Organization
LA COMMUNITY CARE MEDICAL
Active
Other names
LA COMMUNITY CARE MEDICAL ASSOCIATES INC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AUGUSTINE ILUORE MD (MEDICAL DIRECTOR)
(310) 219-2929
Entity
Organization
Contact information
Practice address
11633 HAWTHORNE BLVD STE 103, HAWTHORNE, CA 90250-2323
(310) 219-2929
(310) 219-2940
Mailing address
11633 HAWTHORNE BLVD STE 103, HAWTHORNE, CA 90250-2323
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A053317
CA
207R00000X
Internal Medicine Physician
A053317
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0081270
—
CA
Enumeration date
06/08/2007
Last updated
04/14/2017
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