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NPI Code Detail

MEDICARE: UCLA UROLOGY ASSOCIATES

MEDICARE: UCLA UROLOGY ASSOCIATES
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
1208800000XUrology Physician

General Provider Information

NPI Number : 1285692822
Entity Type Code : Organization
Provider Name (Legal Business Name) : UCLA UROLOGY ASSOCIATES
Provider Business Mailing Address
First Line : FILE 2939
Second Line :
City : LOS ANGELES
State : CA
Zip : 90074-2939
Country : US
Telephone Number : 310-301-8708
Fax Number : 310-301-8751
Provider Business Practice Location Address
First Line : 1260 15TH ST
Second Line : SUITE 1200
City : SANTA MONICA
State : CA
Zip : 90404-1135
Country : US
Telephone Number : 310-451-8751
Fax Number :
Authorized Official
Title or Position : PROFFESSOR AND CHAIR
Name : DR. JEAN B DEKERNION
Credential : M.D.
Telephone Number : 310-306-6453
Provider Enumeration Date : 05/03/2006
Last Update Date : 06/27/2008

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Directions to “UCLA UROLOGY ASSOCIATES ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.