Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Provider Service Network, Inc

Organization Family Medicine Physician · NPI 1336700012

Provider Service Network, Inc is a Family Medicine Physician in Los Angeles, California. Registered with an NPI since 2019.

In the registry since
2019
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

212 Bailey St Apt 204
Los Angeles, CA 90033-2460
Phone: (323) 264-5000
Fax: (323) 264-5003
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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

Record details

NPI number1336700012
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Hector Castillo — Ceo · (323) 264-5000
NPI enumeratedJune 24, 2019
Last updated in NPPESJune 25, 2019
Mailing address212 Bailey St Apt 204, Los Angeles, CA 90033-2460

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