Basic Information
| Provider Information | |||||||||
| NPI: | 1598364697 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | COUNTY OF LOS ANGELES | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | BELL HEALTH CENTER | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1000 S. FREMONT AVE. | ||||||||
| Address2: | UNIT #9, BLDG A11, GROUND FL. | ||||||||
| City: | ALHAMBRA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 918038801 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6265256076 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 6901 ATLANTIC AVE | ||||||||
| Address2: | |||||||||
| City: | BELL | ||||||||
| State: | CA | ||||||||
| PostalCode: | 902013646 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3108687600 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/20/2020 | ||||||||
| LastUpdateDate: | 07/13/2021 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | O'BRIEN | ||||||||
| AuthorizedOfficialFirstName: | QUENTIN | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | AMBULATORY CARE NETWORK, CEO | ||||||||
| AuthorizedOfficialTelephone: | 2132889000 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | COUNTY OF LOS ANGELES | ||||||||
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| NPICertificationDate: | 07/13/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261Q00000X | Y | Ambulatory Health Care Facilities | Clinic/Center |
No ID Information.