Organization
ADVANCED COMMUNITY MEDICAL CARE CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDALL WHITAKER MAXEY MD (PRESIDENT)
(310) 680-1810
Entity
Organization
Contact information
Practice address
323 N PRAIRIE AVE, SUITE 417, INGLEWOOD, CA 90301-4502
(310) 680-1810
Mailing address
447 N PRAIRIE AVE, INGLEWOOD, CA 90301-4502
(310) 680-1810
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
06/10/2016
Last updated
10/02/2019
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