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.

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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

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Submit disability determination packets to DDSD LA-SPB; Presumptive Disability (PD) requests are faxed to (310) 615-2713.

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