Provider Demographics
NPI:1295131209
Name:GOODWILL COMMUNITY HEALTH CENTER INC.
Entity type:Organization
Organization Name:GOODWILL COMMUNITY HEALTH CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GOR
Authorized Official - Middle Name:
Authorized Official - Last Name:MURADYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:213-413-4777
Mailing Address - Street 1:2011 BEVERLY BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90057-2403
Mailing Address - Country:US
Mailing Address - Phone:213-413-4777
Mailing Address - Fax:213-413-4778
Practice Address - Street 1:2011 BEVERLY BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057-2403
Practice Address - Country:US
Practice Address - Phone:213-413-4777
Practice Address - Fax:213-413-4778
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-18
Last Update Date:2014-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty