Healthcare Provider Details

I. General information

NPI: 1447625959
Provider Name (Legal Business Name): COUNTY OF LOS ANGELES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2015
Last Update Date: 12/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5555 FERGUSON DR
COMMERCE CA
90022-5164
US

IV. Provider business mailing address

44900 60TH ST W
LANCASTER CA
93536-7618
US

V. Phone/Fax

Practice location:
  • Phone: 323-890-7509
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ART BERNAL
Title or Position: REVENUE MANAGER
Credential:
Phone: 323-890-7775