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General NPI Number Information
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NPI Number | 1477085330
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Entity Type | Organization
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Legal Business Name | NYUL AEGD
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Dates
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Enumeration Date | 03/30/2017
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Last Update Date | 03/30/2017
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Provider Practice Location Address
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Address Line | 3743 S LABREA AVENUE
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City | LOS ANGELES
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State | CA
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Zip | 90016
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Country | US
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Telephone | 323-329-9005
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Fax | 323-294-3949
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Provider Business Mailing Address
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Address Line | 13346 CHASE ST
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City | ARLETA
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State | CA
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Zip | 91331-5719
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Country | US
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Telephone | 818-671-7268
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Fax |
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Authorized Official
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Title or Position | RESIDENT
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Name | KEVIN CHOI
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Credential |
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Telephone | 818-671-7268
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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