Organization · Type 2 NPI

County of Los Angeles

Clinic/Center · Palmdale, CA

NPI number 1720090616 Active

Practice location

16921 E Avenue O Ste G
Palmdale, CA 93591-3045

Specialties and licenses

Taxonomy	Code	License
Clinic/Center Primary	261Q00000X	None listed

Clinic/Center: A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

8 other providers at this address

Other clinic/center providers in Palmdale

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NPI record

NPI: 1720090616
Entity type: Organization (Type 2)
Issued: Aug 12, 2006
Last updated: Dec 26, 2018
Status: Active
Subpart: Yes of County of Los Angeles

Other names

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Lake Los Angeles Community Clinic · doing business as
Lake Los Angeles Community Clinic · doing business as

Authorized official

Ms. Beryl Brooks
Clinic Administrator
(323) 890-7775

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1720090616

County of Los Angeles's National Provider Identifier is 1720090616, issued on Aug 12, 2006. The primary taxonomy on file is Clinic/Center (261Q00000X), and the practice location is in Palmdale, CA. The record was last updated on Dec 26, 2018.