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Organization

MARTIN LUTHER KING JR. MULTISERVICE AMBULATORY CARE CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. CAROLYN S. CLARK (CEO)
(310) 668-5201
Entity
Organization

Contact information

Practice address
12021 WILMINGTON AVE, ROOM# B068, LOS ANGELES, CA 90059-3019
(310) 668-3966
Mailing address
12021 WILMINGTON AVE, LOS ANGELES, CA 90059-3019
(310) 668-4321

Taxonomy

Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
Primary
PHE 14221
CA

Other

Enumeration date
01/14/2009
Last updated
01/14/2009
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