Healthcare Provider Details

I. General information

NPI: 1346389905
Provider Name (Legal Business Name): LOS ANGELES DOCTORS CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 07/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2231 SOUTH WESTERN AVE
LOS ANGELES CA
90018-9903
US

IV. Provider business mailing address

2231 SOUTH WESTERN AVE
LOS ANGELES CA
90018-9903
US

V. Phone/Fax

Practice location:
  • Phone: 323-730-7300
  • Fax: 949-732-4671
Mailing address:
  • Phone: 323-730-7300
  • Fax: 949-732-4671

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License Number930000187
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number930000187
License Number StateCA

VIII. Authorized Official

Name: MR. GARY LEWIS
Title or Position: VP/HOSPITAL CFO
Credential:
Phone: 323-377-6842