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Hollywood Fountain Medical Group

Debarred entity

Hollywood Fountain Medical Group is an entity of interest. It has not been found on international sanctions lists.

Type	Company				[sources]
Name	Hollywood Fountain Medical Group				[sources]
Incorporation date	not available				[sources]
Jurisdiction	not available				[sources]
Country	United States				[sources]
Description	Provider number(s): GR0012150, GR0019100, 00C188270				[sources]
Registration number	not available				[sources]
Sector	Physician Group				[sources]
Address	6234 Fountain Ave., Los Angeles, CA				[sources]
Last change	2024-11-07	Last processed	2024-11-07	First seen	2024-11-07

Sanctions
Authority	Program	Start date	End date
Department of Health Care Services	-	1985-10-31	-

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

United States · DHCS

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