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Hollywood Fountain Medical Group

Debarred entity
TypeCompany[sources]
NameHollywood Fountain Medical Group[sources]
Incorporation datenot available[sources]
Jurisdictionnot available[sources]
CountryUnited States[sources]
Registration number00C188270 · GR0012150 · GR0019100[sources]
SectorPhysician Group[sources]
Address6234 Fountain Ave., Los Angeles, CA[sources]
Last changeLast processedFirst seen

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Data sources

US California Medicaid Suspended and ineligible providers22,477

Medical providers suspended from or otherwise deemed ineligible to participate in California's Medicaid program.

United States · DHCS


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