OrganizationActive
Martin Luther King Jr. Multiservice Ambulatory Care Center
NPI 1629215504 · Clinic Pharmacy · Los Angeles, CA
Provider details
- NPI number
- 1629215504
- Entity type
- Organization
- Primary specialty
- Clinic PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Carolyn Clark, Ceo(310) 668-5201
- License
- PHE 14221 (CA)
Specialties & taxonomies
Suppliers
Practice location
12021 Wilmington Ave
Room# B068
Los Angeles, CA 90059-3019
Phone: (310) 668-3966
Approximate (ZIP-level) locationGet directions
Mailing address
12021 Wilmington Ave
Los Angeles, CA 90059-3019
Registry dates
- Enumerated
- 2009-01-14
- Last updated
- 2009-01-14
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.