FOMUKONG HEALTH FOUNDATION INC
Managed Care Organizations at Westwood Blvd, Los Angeles, CA

License number
California 2768722
Category
Managed Care Organizations
Type
Preferred Provider Organization
Owner
Name: MR. NDIKA FOMUKONG FNP/PAC
Title: CHIEF EXECUTIVE OFFICER
Phone: (310) 701-6703
Address
Address
2355 Westwood Blvd #332, Los Angeles, CA 90064
National Provider ID: 1861732190
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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THE FOMUKONG HEALTH FOUNDATION INC

Los Angeles, CA  -  King City, CA

Industry:
Civic/Social Association
Doing business as:
Fomukong Health Foundation Inc
Registration:
Jul 27, 2005
Addresses:
2355 Westwood Blvd #332, Los Angeles, CA 90064 (Physical)
10853 Rose Ave, Los Angeles, CA 90034
635 Sherwood Ave, King City, CA 93930
State ID:
C2768722
Business type:
Articles of Incorporation
President:
Ndika Fomukong (President)

Fomukong Health Foundation Inc

PO Box 341521, Los Angeles, CA 90034

Status:
Inactive
Industry:
Health/Allied Services

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