Organization
THE ELIZABETH CENTER FOR CANCER DETECTION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD M COOK (CEO)
(213) 977-8920
Entity
Organization
Contact information
Practice address
1127 WILSHIRE BLVD, SUITE 1000, LOS ANGELES, CA 90017-4001
(213) 481-2511
(213) 481-1913
Mailing address
1127 WILSHIRE BLVD, SUITE 1000, LOS ANGELES, CA 90017-4001
(213) 481-2511
(213) 481-1913
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
960000031
CA
261QM1300X
Multi-Specialty Clinic/Center
960000031
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CMM70685F
—
CA
01
—
ZZZ53363Z
BLUE SHIELD OF CALIF
CA
Enumeration date
03/21/2006
Last updated
02/17/2010
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