Organization
MARTIN LUTHER KINGJR-MULTI-SERVICE AMBULATORY CARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CAROLYN S. CLARK (ADMINISTRATOR)
(310) 668-5201
Entity
Organization
Contact information
Practice address
12021 SOUTH WILMINGTON AVE, LOS ANGELES, CA 90059
(310) 668-3972
(310) 687-2960
Mailing address
12021 SOUTH WILMINGTON AVE, LOS ANGELES, CA 90059
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
Primary
PHE14222
CA
Other
Enumeration date
05/09/2007
Last updated
03/12/2009
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