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
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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