Organization
COUNTY OF LOS ANGELES AUDITOR CONTROLLER
Active
Parent organization
COUNTY OF LOS ANGELES AUDITOR CONTROLLER
Other names
Martin Luther King, Jr. Outpatient Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
COUNTY OF LOS ANGELES AUDITOR CONTROLLER
Authorized official
MS. CYNTHIA OLIVER (ADMINISTRATOR)
(424) 338-1001
Entity
Organization
Contact information
Practice address
1670 E 120TH ST, LOS ANGELES, CA 90059-3026
(310) 668-5201
Mailing address
1670 E 120TH ST, LOS ANGELES, CA 90059-3026
(310) 668-5201
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
60000132
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HSW30578F
CALOPTIMA - MLK IP
CA
01
—
ZZW40578F
CALOPTIMA - MLK OP
CA
01
—
ZZZJ1910Z
BLUE SHIELD - MLK OP
CA
Enumeration date
12/14/2006
Last updated
01/21/2015
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