Organization
THE LOS ANGELES FREE CLINIC
Active
Other names
Saban Community Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MURIEL NOUWEZEM (CEO)
(323) 337-1707
Entity
Organization
Contact information
Practice address
137 N VIRGIL AVE, LOS ANGELES, CA 90004-4811
(323) 337-1707
Mailing address
8405 BEVERLY BLVD, LOS ANGELES, CA 90048-3401
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CMM70945F
—
CA
05
—
EAP00005F
—
CA
05
—
FHC70654F
—
CA
05
—
HAP70654F
—
CA
05
—
HAP70701F
—
CA
Enumeration date
03/21/2018
Last updated
06/14/2021
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