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General NPI Number Information
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NPI Number | 1336534908
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Entity Type | Organization
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Legal Business Name | HARBOR UCLA MEDICAL CENTER
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Dates
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Enumeration Date | 04/01/2015
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Last Update Date | 04/01/2015
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Provider Practice Location Address
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Address Line | 1000 W CARSON ST OPHTHALMOLOGY CLINIC BOX 6
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City | CARSON
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State | CA
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Zip | 90810-1408
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Country | US
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Telephone | 310-222-2735
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Fax |
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Provider Business Mailing Address
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Address Line | 1000 W CARSON ST OPHTHALMOLOGY CLINIC BOX 6
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City | CARSON
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State | CA
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Zip | 90810-1408
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Country | US
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Telephone | 310-222-2735
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Fax |
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Authorized Official
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Title or Position | NP
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Name | EVANGELINE OJALES
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Credential | NURSE PRACTITIONER
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Telephone | 818-693-4458
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS0132X
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Taxonomy Name | Ophthalmologic Surgery Clinic/Center
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License Number | 363LXF0000X
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License Number State | CA
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