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General NPI Number Information
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NPI Number | 1114132685
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Entity Type | Organization
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Legal Business Name | ALTA LOS ANGELES HOSPITAL, INC
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Dates
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Enumeration Date | 05/10/2007
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Last Update Date | 02/04/2021
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Provider Practice Location Address
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Address Line | 4081 E OLYMPIC BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90023-3330
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Country | US
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Telephone | 323-881-2600
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Fax | 323-261-0809
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Provider Business Mailing Address
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Address Line | 4081 E OLYMPIC BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90023-3330
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Country | US
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Telephone | 323-881-2600
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Fax | 323-261-0809
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Authorized Official
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Title or Position | SECRETARY
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Name | ROBERT JON ELDERS
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Credential |
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Telephone | 714-788-1249
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 930000039
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License Number State | CA
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