Organization
VIA CARE COMMUNITY HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NINA FALCETTI (DIRECTOR OF HR)
(323) 268-9191
Entity
Organization
Contact information
Practice address
507 S ATLANTIC BLVD, LOS ANGELES, CA 90022-2621
(323) 268-9191
(323) 268-9119
Mailing address
507 S ATLANTIC BLVD, LOS ANGELES, CA 90022-2621
(323) 268-9191
(323) 268-9119
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
261QC1500X
Community Health Clinic/Center
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
751121
MEDICARE PTAN
CA
01
—
HG353A
MEDICARE PTAN
CA
Enumeration date
07/30/2012
Last updated
02/22/2022
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