Directory information, not recipient confirmation. Fax numbers can change and differ by department, location, form, or plan. Confirm this destination directly with Disability Determination Services Division (DDSD) – Los Angeles State Programs Branch (LA-SPB), Medi-Cal Eligibility Division, California Department of Health Care Services (DHCS) before sending sensitive documents. FaxFlow is not affiliated with this organization.
Disability Determination Services Division (DDSD) – Los Angeles State Programs Branch (LA-SPB), Medi-Cal Eligibility Division, California Department of Health Care Services (DHCS) fax number
(310) 615-2713
Disability Determination Services Division (DDSD) – Los Angeles State Programs Branch (LA-SPB)
Used for: Presumptive Disability (PD) requests
Fax destination details
- Department
- Disability Determination Services Division (DDSD) – Los Angeles State Programs Branch (LA-SPB)
- Purpose
- Presumptive Disability (PD) requests
- Form
- MC-221 LA (Disability Determination and Transmittal) / MC-221-LA — Disability Determination and Transmittal (MC 221 LA)
- Address
- P.O. Box 992, El Segundo, CA 90245-0992 (Los Angeles State Programs Branch, Disability Determination Services Division)
- Voice phone
- (310) 615-2800
- Website
- Visit organization website
Before you send
- Confirm that this exact department handles your document or request.
- Check the organization website or call its main line for the current fax number.
- Include a cover sheet and any case, member, claim, or form reference required.
- Keep the delivery confirmation with your submission records.
Submit disability determination packets to DDSD LA-SPB; Presumptive Disability (PD) requests are faxed to (310) 615-2713.
Official form instructions are published as a downloadable file on the organization's website.
Sources and verification
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