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General NPI Number Information
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NPI Number | 1558819391
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Entity Type | Organization
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Legal Business Name | UNIVERSITY OF SOUTHERN CALIFORNIA
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Dates
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Enumeration Date | 09/21/2016
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Last Update Date | 09/21/2016
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Provider Practice Location Address
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Address Line | 1441 EASTLAKE AVENUE, SUITE 3440
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City | LOS ANGELES
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State | CA
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Zip | 90033-4972
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Country | US
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Telephone | 323-865-3962
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Fax | 323-865-0061
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Provider Business Mailing Address
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Address Line | 1441 EASTLAKE AVENUE, SUITE 3440
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City | LOS ANGELES
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State | CA
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Zip | 90033-4972
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Country | US
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Telephone | 323-865-3962
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Fax | 323-865-0061
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Authorized Official
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Title or Position | CLINICAL PROFESSOR
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Name | MIN JANICE LU
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Credential | MD
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Telephone | 323-865-3962
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | C130396
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License Number State | CA
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