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General NPI Number Information
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NPI Number | 1669808879
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Entity Type | Organization
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Legal Business Name | LAC-USC
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Dates
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Enumeration Date | 09/19/2013
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Last Update Date | 09/19/2013
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Provider Practice Location Address
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Address Line | 1200 N STATE ST 5TH FLOOR, ANESTHESIA
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City | LOS ANGELES
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State | CA
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Zip | 90033-1029
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Country | US
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Telephone | 310-880-7341
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Fax |
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Provider Business Mailing Address
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Address Line | 23953 RUSTICO CT
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City | VALENCIA
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State | CA
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Zip | 91354-1559
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Country | US
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Telephone | 310-880-7341
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Fax |
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Authorized Official
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Title or Position | CHIEF CRNA
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Name | KARI COLE
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Credential | CRNA
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Telephone | 323-409-7735
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number | 713419
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License Number State | CA
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