MEDICARE: NATIONAL INSTITUTE OF TRANSPLANTATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	291U00000X	Clinical Medical Laboratory	CLF11589	CA

General Provider Information

NPI Number	:	1093880650
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NATIONAL INSTITUTE OF TRANSPLANTATION

Provider Business Mailing Address
First Line	:	2200 W 3RD ST
Second Line	:	SUITE 100
City	:	LOS ANGELES
State	:	CA
Zip	:	90057-1932
Country	:	US
Telephone Number	:	213-413-2779
Fax Number	:	213-484-6652

Provider Business Practice Location Address
First Line	:	2200 W 3RD ST
Second Line	:	SUITE 100
City	:	LOS ANGELES
State	:	CA
Zip	:	90057-1932
Country	:	US
Telephone Number	:	213-413-2779
Fax Number	:	213-484-6652

Authorized Official
Title or Position	:	CEO
Name	:	JUSTIN DOOLEY
Credential	:
Telephone Number	:	213-413-2779

Provider Enumeration Date	:	11/21/2006
Last Update Date	:	08/22/2020

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Directions to “NATIONAL INSTITUTE OF TRANSPLANTATION ” Practice Location

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