Healthcare Provider Details

I. General information

NPI: 1003929829
Provider Name (Legal Business Name): COUNTY OF LOS ANGELES AUDITOR CONTROLLER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2006
Last Update Date: 05/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

335 E AVENUE I
LANCASTER CA
93535-1916
US

IV. Provider business mailing address

335 E AVENUE I
LANCASTER CA
93535-1916
US

V. Phone/Fax

Practice location:
  • Phone: 661-948-8581
  • Fax:
Mailing address:
  • Phone: 661-948-8581
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: VIRGINIA PEREZ
Title or Position: CHIEF, CONSOLIDATED BUSINESS OFFICE
Credential:
Phone: 323-914-7622