Healthcare Provider Details

I. General information

NPI: 1790718500
Provider Name (Legal Business Name): USC UNIVERSITY HOSPITAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2006
Last Update Date: 05/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 SAN PABLO ST
LOS ANGELES CA
90033-5313
US

IV. Provider business mailing address

FILE 57446
LOS ANGELES CA
90074-7446
US

V. Phone/Fax

Practice location:
  • Phone: 323-442-8500
  • Fax:
Mailing address:
  • Phone: 209-578-2513
  • Fax: 805-434-2913

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License Number930000459
License Number StateCA

VIII. Authorized Official

Name: MR. CRAIG C. ARMIN
Title or Position: VP OF GOVT PROGRAMS, TENET
Credential:
Phone: 310-775-8043