Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Primary Care Health Clinic

Organization Family Medicine Physician · NPI 1891134268

Primary Care Health Clinic provides Family Medicine Physician services in Los Angeles, California. Licensed in California. Registered with an NPI since 2013.

Licensed in
CA
In the registry since
2013
Specialties on file
5
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Practice location Address checks out

1601 W Washington Blvd
Los Angeles, CA 90007-1116 Not confirmed with CMS for 10 years — call before visiting
Phone: (310) 701-6703
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 34954 (CA)
Internal Medicine Physician Taxonomy 207R00000X · Licence 34954 (CA)
Obstetrics & Gynecology Physician Taxonomy 207V00000X · Licence 34954 (CA)
Gynecology Physician Taxonomy 207VG0400X · Licence 34954 (CA)
General Practice Physician Taxonomy 208D00000X · Licence 34954 (CA)

Record details

NPI number1891134268
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Ndika Fomukong — Ceo · (310) 701-6703
NPI enumeratedJune 19, 2013
Last updated in NPPESJanuary 13, 2016
Mailing address1601 W Washington Blvd, Los Angeles, CA 90007-1116

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