Organization
TRI-STATE COMMUNITY HEALTHCARE CENTER
Active
Parent organization
TRI-STATE COMMUNITY HEALTHCARE CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
TRI-STATE COMMUNITY HEALTHCARE CENTER
Authorized official
CRYSTALE MINEROS (MANAGED CARE DIRECTOR)
(323) 297-0884
Entity
Organization
Contact information
Practice address
4137 VERDUGO RD, LOS ANGELES, CA 90065-3820
(323) 928-5052
Mailing address
4137 VERDUGO RD, LOS ANGELES, CA 90065-3820
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
05/01/2019
Last updated
04/30/2021
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