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General NPI Number Information
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NPI Number | 1659509206
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Entity Type | Organization
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Legal Business Name | USC CARE MEDICAL NON-CONTRACTED LLC
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Dates
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Enumeration Date | 06/22/2009
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Last Update Date | 05/01/2023
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Provider Practice Location Address
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Address Line | 1520 SAN PABLO ST
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City | LOS ANGELES
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State | CA
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Zip | 90033-5310
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Country | US
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Telephone | 323-442-5100
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 31309
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City | LOS ANGELES
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State | CA
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Zip | 90031-0309
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Country | US
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Telephone | 626-457-4145
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Fax | 626-457-5811
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER, USC CARE
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Name | JEREMY CHURCH
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Credential |
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Telephone | 323-442-8747
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number |
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License Number State |
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