Healthcare Provider Details

I. General information

NPI: 1821034315
Provider Name (Legal Business Name): USC SURGEONS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2006
Last Update Date: 02/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1510 SAN PABLO ST SUITE 514
LOS ANGELES CA
90033-5324
US

IV. Provider business mailing address

1510 SAN PABLO ST SUITE 514
LOS ANGELES CA
90033-5324
US

V. Phone/Fax

Practice location:
  • Phone: 323-442-5910
  • Fax: 323-442-6798
Mailing address:
  • Phone: 323-442-5923
  • Fax: 323-442-6798

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: ERIC ALCORN
Title or Position: EXECUTIVE VICE PRESIDENT
Credential:
Phone: 323-442-5923