GRACELIGHT COMMUNITY HEALTH

NPI # 

Practice Address:

4618 Fountain Ave

Los Angeles, CA, 90029-1830

Practice Phone:

323-953-7170

Practice Fax:

323-663-2379

License Number:

960000926

License State:

CA

Taxonomy Grouping:

Ambulatory Health Care Facilities

Taxonomy Classification:

Clinic/Center

Taxonomy Specialization:

Federally Qualified Health Center (FQHC)

Taxonomy Code:

261QF0400X