Healthcare Provider Details

I. General information

NPI: 1902045131
Provider Name (Legal Business Name): UNIVERSITY OF SOUTHERN CALIFORNIA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2009
Last Update Date: 11/22/2011
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

1500 SAN PABLO ST ATTN: JONATHAN J. SPEES, CFO
LOS ANGELES CA
90033-5313
US

V. Phone/Fax

Practice location:
  • Phone: 323-442-8500
  • Fax: 323-442-8672
Mailing address:
  • Phone: 323-442-8444
  • Fax: 323-442-5257

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number930000459
License Number StateCA

VIII. Authorized Official

Name: MR. TODD R. DICKEY
Title or Position: SENIOR VICE PRESIDENT ADMINISTRATIO
Credential:
Phone: 213-740-7922