Organization
LATINO KIDS HEALTH
Active
Other names
LK Health
Organization subpart
No
Provider details
NPI number
Authorized official
ETELVINA DE LA TORRE (CO-CEO)
(323) 728-8588
Entity
Organization
Contact information
Practice address
901 W WHITTIER BLVD, MONTEBELLO, CA 90640-4737
(323) 728-8588
(323) 728-4444
Mailing address
901 W WHITTIER BLVD, MONTEBELLO, CA 90640-4737
(323) 728-8588
(323) 728-4444
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
220796
BUSINESS LICENSE CERTIFICATE
CA
01
—
550002916
PUBLIC HEALTH LICENSE
CA
Enumeration date
02/27/2015
Last updated
02/27/2015
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