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General NPI Number Information
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NPI Number | 1659552636
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Entity Type | Organization
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Legal Business Name | CHILDREN'S HOSPITAL LOS ANGELES
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Dates
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Enumeration Date | 11/19/2007
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Last Update Date | 10/21/2021
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Provider Practice Location Address
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Address Line | 4650 W SUNSET BLVD RM 1503
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City | LOS ANGELES
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State | CA
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Zip | 90027-6062
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Country | US
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Telephone | 323-361-8839
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Fax | 323-361-7135
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Provider Business Mailing Address
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Address Line | 4650 W SUNSET BLVD RM 1401 MAILBOX NUMBER 44
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City | LOS ANGELES
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State | CA
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Zip | 90027-6062
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SR. VP/CFO
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Name | MR. MAX SCOTT LIEBERENZ
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Credential | CPA
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Telephone | 323-361-2235
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336I0012X
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Taxonomy Name | Institutional Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number |
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License Number State |
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