Organization
UNITED STATES SPACE FORCE
Active
Other names
LAAFB, GRT, Space Base Delta 3, Guardian Resilence Team, Los Angeles Air Force Base
Organization subpart
No
Provider details
NPI number
Authorized official
COLIN LIM (NH-3)
(310) 653-1110
Entity
Organization
Contact information
Practice address
483 N AVIATION BLVD BLDG 286, EL SEGUNDO, CA 90245-2808
(310) 653-1110
Mailing address
483 N AVIATION BLVD BLDG 286, EL SEGUNDO, CA 90245-2808
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
Primary
—
—
Other
Enumeration date
09/16/2025
Last updated
09/23/2025
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