Organization
URDC HUMAN SERVICES CORPORATION
Active
Other names
Bill Moore Community Health Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AL SORKIN PH.D. (EXECUTIVE DIRECTOR)
(626) 398-3796
Entity
Organization
Contact information
Practice address
1460 N LAKE AVE, PASADENA, CA 91104-2300
(626) 398-3796
(626) 398-3895
Mailing address
1460 N LAKE AVE, P.O. BOX 41274, PASADENA, CA 91104-2300
(626) 398-3796
(626) 398-3895
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
CMM70645F
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CMM70645F
—
CA
01
—
W16126
PIN
—
Enumeration date
06/22/2006
Last updated
08/22/2020
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