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NPI Code Detail

MEDICARE: LOS ANGELES COUNTY - DEPARTMENT OF HEALTH SERVICES

MEDICARE: LOS ANGELES COUNTY - DEPARTMENT OF HEALTH SERVICES
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
1363A00000XPhysician Assistant

General Provider Information

NPI Number : 1174549711
Entity Type Code : Organization
Provider Name (Legal Business Name) : LOS ANGELES COUNTY - DEPARTMENT OF HEALTH SERVICES
Provider Business Mailing Address
First Line : 5555 FERGUSON DR
Second Line : SUITE 310-15
City : COMMERCE
State : CA
Zip : 90022-5152
Country : US
Telephone Number : 323-890-7775
Fax Number :
Provider Business Practice Location Address
First Line : 5850 S MAIN ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90003-1215
Country : US
Telephone Number : 323-846-4312
Fax Number :
Authorized Official
Title or Position : ASSOCIATE HOSPITAL ADMINISTRATOR II
Name : MR. ART BERNAL
Credential :
Telephone Number : 323-890-7775
Provider Enumeration Date : 07/15/2006
Last Update Date : 08/22/2020

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Directions to “LOS ANGELES COUNTY - DEPARTMENT OF HEALTH SERVICES ” Practice Location

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