Organization
THE LOS ANGELES FREE CLINIC
Active
Organization
THE LOS ANGELES FREE CLINIC
Active
Other names
Saban Community Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MURIEL NOUWEZEM (CEO)
(323) 337-1707
Entity
Organization
Contact information
Practice address
5205 MELROSE AVE, LOS ANGELES, CA 90038-3144
(323) 653-8622
Mailing address
5205 MELROSE AVE, LOS ANGELES, CA 90038-3144
(323) 653-8622
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
960001353
CA
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
BCP70654F
—
CA
05
—
BCP70701F
—
CA
05
—
CMM70945F
—
CA
05
—
EAP00005F
—
CA
05
—
FHC70654F
—
CA
05
—
FHC70701F
—
CA
05
—
HAP70654F
—
CA
05
—
HAP70701F
—
CA
Enumeration date
02/12/2007
Last updated
08/30/2024
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