Healthcare Provider Details

I. General information

NPI: 1487676409
Provider Name (Legal Business Name): COUNTY OF LOS ANGELES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 05/09/2022
Certification Date: 05/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 W CARSON ST
TORRANCE CA
90502-2004
US

IV. Provider business mailing address

1000 W CARSON ST
TORRANCE CA
90502-2004
US

V. Phone/Fax

Practice location:
  • Phone: 424-306-6580
  • Fax:
Mailing address:
  • Phone: 424-306-6580
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License Number60000129
License Number StateCA

VIII. Authorized Official

Name: MR. ANISH MAHAJAN
Title or Position: CEO
Credential: MD
Phone: 424-306-6580