Organization
COUNTY OF LOS ANGELES
Active
Other names
CHS - Century Regional Detention Facility
Organization subpart
No
Provider details
NPI number
Authorized official
SEAN HENDERSON MD (CHIEF MEDICAL OFFICER)
(213) 893-5304
Entity
Organization
Contact information
Practice address
11705 S. ALAMEDA ST, LYNWOOD, CA 90262-4023
(323) 568-4555
(323) 415-3987
Mailing address
1000 S. FREMONT. AVE., UNIT #9, BLDG A11, GROUND FL, SUITE A11010, ALHAMBRA, CA 91803-8801
(626) 525-6076
Taxonomy
Speciality
Code
Description
License number
State
3336I0012X
Institutional Pharmacy
Primary
LCF47461
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5628334
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
05/02/2007
Last updated
10/03/2023
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