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General NPI Number Information
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NPI Number | 1184966210
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Entity Type | Organization
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Legal Business Name | UCLA HEALTH SYSTEMS
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Dates
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Enumeration Date | 03/27/2013
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Last Update Date | 03/27/2013
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Provider Practice Location Address
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Address Line | 200 MEDICAL PLZ SUITE 660
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City | LOS ANGELES
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State | CA
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Zip | 90095-0001
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Country | US
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Telephone | 310-794-9206
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Fax | 310-794-9630
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Provider Business Mailing Address
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Address Line | 200 MEDICAL PLZ SUITE 660
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City | LOS ANGELES
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State | CA
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Zip | 90095-0001
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Country | US
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Telephone | 310-794-9206
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Fax | 310-794-9630
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Authorized Official
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Title or Position | NURSE PRACTIONER
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Name | MS. MERIBETH DAWN HART
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Credential | MSN NP
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Telephone | 310-794-9206
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 655119
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 655119
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License Number State | CA
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