Organization
URDC HUMAN SERVICES CORPORATION
Active
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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