61ST MED SQ-LOS ANGELES

EL SEGUNDO, CA
NPI1538145412
Entity TypeOrganization
Authorized ContactJEN LEWANDOWSKI
Dha Ubo
703-817-4030
Organization Subpart ?Yes
Primary Taxonomy261QM1100X Clinic/Center, MilitaryU.S. Coast Guard Outpatient
Additional Taxonomies261QM1101X Clinic/Center, Military and U.S. Coast Guard Ambulatory Procedure
332000000X MilitaryU.S. Coast Guard Pharmacy
Enumeration Date2005-12-21
Last Update Date2025-06-17
Business Address
61ST MED SQ-LOS ANGELES
2420 VELA WAY SUITE 1866
EL SEGUNDO, CA 90245-4659
Phone number: 310-363-6640
Mailing Address
61ST MED SQ-LOS ANGELES
2420 VELA WAY STE 1467
EL SEGUNDO, CA 90245-4659
Phone number: 310-653-6437