Organization
COUNTY OF LOS ANGELES AUDITOR CONTROLLER
Active
Parent organization
COUNTY OF LOS ANGELES AUDITOR CONTROLLER
Other names
Lake Los Angeles Community Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
COUNTY OF LOS ANGELES AUDITOR CONTROLLER
Authorized official
MS. BERYL BROOKS (CLINIC ADMINISTRATOR)
(661) 471-4200
Entity
Organization
Contact information
Practice address
16921 E AVENUE O STE G, PALMDALE, CA 93591-3045
(661) 945-8444
Mailing address
16921 E AVENUE O STE G, PALMDALE, CA 93591-3045
(661) 945-8444
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
HAP16012F
—
CA
Enumeration date
08/06/2010
Last updated
03/05/2015
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