Healthcare Provider Details

I. General information

NPI: 1417364811
Provider Name (Legal Business Name): COUNTY OF LOS ANGELES - AUDITOR CONTROLLER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2014
Last Update Date: 04/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

313 N FIGUEROA ST SUITE 1225
LOS ANGELES CA
90012-2602
US

IV. Provider business mailing address

313 N FIGUEROA ST SUITE 1225
LOS ANGELES CA
90012-2602
US

V. Phone/Fax

Practice location:
  • Phone: 213-240-7717
  • Fax: 213-975-9623
Mailing address:
  • Phone: 213-240-7717
  • Fax: 213-975-9623

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License NumberPHE 51883
License Number StateCA

VIII. Authorized Official

Name: DR. SHANE DSOUZA
Title or Position: PHARMACY SERVICES CHIEF
Credential: PHARM.D.
Phone: 213-240-7717