Healthcare Provider Details

I. General information

NPI: 1528162229
Provider Name (Legal Business Name): COUNTY OF LOS ANGELES AUDITOR CONTROLLER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2006
Last Update Date: 04/14/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7601 IMPERIAL HWY
DOWNEY CA
90242-3456
US

IV. Provider business mailing address

PO BOX 514316 TERMINAL ANNEX
LOS ANGELES CA
90051-2316
US

V. Phone/Fax

Practice location:
  • Phone: 562-803-0124
  • Fax: 562-803-5569
Mailing address:
  • Phone: 562-803-0124
  • Fax: 562-803-5569

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: MINDY AISEN
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 562-803-0124