Organization
UNIVERSAL COMMUNITY HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALFREDO REYNOSO (COO)
(323) 233-3100
Entity
Organization
Contact information
Practice address
1021 W MARTIN LUTHER KING JR BLVD, LOS ANGELES, CA 90037-1816
(323) 233-3100
(323) 233-4100
Mailing address
2801 S SAN PEDRO ST, LOS ANGELES, CA 90011-2023
(323) 233-3100
(323) 233-4100
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
550003832
—
CA
Enumeration date
12/06/2021
Last updated
01/04/2022
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