Organization
COUNTY OF LOS ANGELES AUDITOR CONTROLLER
Active
Parent organization
MLK-AMBULATORY SURGICAL CENTER-RADIOLOGY
Organization subpart
Yes
Provider details
NPI number
Legal business name
MLK-AMBULATORY SURGICAL CENTER-RADIOLOGY
Authorized official
FREDERICK RUTHERFORD DDS (ASSOC MEDICAL DIRECTOR)
(310) 668-4501
Entity
Organization
Contact information
Practice address
12021 WILMINGTON AVE, LOS ANGELES, CA 90059-3019
(310) 668-4501
(310) 763-8909
Mailing address
12021 WILMINGTON AVE, LOS ANGELES, CA 90059-3019
(310) 668-4501
(310) 763-8909
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
CA
Other
Enumeration date
11/28/2007
Last updated
11/28/2007
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