MEDICARE: GREATER LOS ANGELES HEALTH CARE SYSTEM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	282NW0100X	Women's Hospital	C51537	CA

General Provider Information

NPI Number	:	1215960984
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GREATER LOS ANGELES HEALTH CARE SYSTEM

Provider Business Mailing Address
First Line	:	16820 EDGAR ST
Second Line	:
City	:	PACIFIC PALISADES
State	:	CA
Zip	:	90272-3227
Country	:	US
Telephone Number	:	310-478-3711
Fax Number	:	310-268-4086

Provider Business Practice Location Address
First Line	:	11301 WILSHIRE BLVD
Second Line	:	BLDG 500 ROOM # 3209
City	:	LOS ANGELES
State	:	CA
Zip	:	90073-1003
Country	:	US
Telephone Number	:	310-478-3711
Fax Number	:	310-268-4086

Authorized Official
Title or Position	:	DIRECTOR, WOMEN'S HEALTH CLINIC
Name	:	DR. FATMA KHAWAJA BATUMAN
Credential	:	MD
Telephone Number	:	310-478-3711

Provider Enumeration Date	:	07/08/2006
Last Update Date	:	08/22/2020

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